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Objective: Advances in the science of genetics and the development of assisted reproductive techniques focus on the genetic causes of infertility. The aim of this research is to reveal genetic abnormalities in terms of sex chromosome aneuploidy and Y chromosome microdeletions. Material and Methods: A total of 350 patients with azoospermia or severe oligozoospermia were selected. After general examination of the patients and laboratory investigations were performed, cartoypes and Y chromosome microdeletions were examined. Results: A total of 225 infertile men with non-obstructive azoospermia (NOA) and 125 infertile men with oligozoospermia were enrolled into the study. The overall cytogenetic anomaly rate was 16%. Chromosomal changes were detected in 32 of 350 (9.1%) cases. The most common genetic anomaly was 47, XXY (Klinefelter syndrome) and the incidence was 11.5% in NOA group. This rate was 3.2% in oligozoospermia group. Y chromosome microdeletions were detected in 24 (6.8%) patients and similarly, it was observed more frequently in the NOA group than in the oligozoospermia group. Conclusion: The incidence of genetic causes have been increasing with the severity of infertility. As a result, genetic screening and appropriate genetic counseling are needed before the use of assisted reproductive techniques.

Objective: Clinical reasoning is a necessary competence to make the right decision in clinical practice. In order to manage the cases, it is necessary to analyze the case, to determine the causes, to evaluate among those who are compatible with the case and to evaluate the results, to perform appropriate examinations and researches for the purpose, to interpret their results, to eventually exclude and calculate the probabilities, and to identify the diagnosis and solutions. In these processes, clinical reasoning and appropriate decisions are made. There is no consensus in case-based learning and evaluation, clinical reasoning definitions and methodologies, and practices are shaped according to the culture of educators and institutions. In the solution of the case, there is a need for a staged, easy-to-use and evaluation-appropriate model that focuses on clinical reasoning and decision making. Aim of the study, to introduce a case-based clinical reasoning and decision making model and evaluate its effectiveness. Material and Methods: University of Health Sciences Bakırköy. Sadi Konuk Training and Research Hospital, 13 students who received specialization training in the Urology Clinic, and 14 trainers responsible for their education in the Health Sciences University and Affiliated Training and Research Hospitals were included in the study. In post-graduate specialization training, students and educators were asked to apply the method after training on the introduction of the model and application methods. After the applications, an evaluation questionnaire about the usefulness of the model and perceptions of learning was conducted to the trainers and students. Results: The opinions of the educators and students about the model, the model is easily understood, it is easily applied in cases encountered in the clinic, it provides a systematic approach to the solution of the cases, it makes it easier to make differential diagnosis, it provides a versatile perspective, it reduces the possibility of making mistakes, it makes it possible to think about the reason when making decisions, and prevents unnecessary operations. found direction. The students stated that they could understand their knowledge about the model and increase their motivation to learn. The trainers have stated that preparation time for applying the model is more than other methods, students take responsibility for solving the case, the level of knowledge and deficiencies of the model and students are more easily understood, facilitating feedback and providing objectivity of the evaluation. Conclusions: If the case-based clinical reasoning and decision-making is made with the model that the educators and the students share, the possibility of malpractices, unnecessary examinations and interventions will be reduced, and the ability to make more conscious and evidence-based decisions will be increased.

Objective:The pre-op differentiation of testicular tumors from paratesticular masses cannot be made clearly. Generally, radical orchiectomy is performed with pre-diagnosis of testicular tumor and a clinical approach is planned according to the final pathological result.When clinicians diagnose a scrotal mass, they should considered that this mass may be originated from epididymidis, tunica vaginalis, spermatic cord, fat-muscle-connective tissue, and embryonic remnants and should determine the treatment management accordingly. Materials and Methods:The pathology results of 140 patients, who were admitted to our center between 2008 and 2018 presenting scrotal mass and underwent inguinal radical orchiectomy considering as testicular tumor, were retrospectively analyzed. Preoperative and postoperative data, clinical course, and treatment management of the cases reported to be paratesticular mass by pathology were discussed in the light of the literature. Results:Paratesticular mass(PTM)was detected in 13 cases of our retrospectively analyzed series. Of these, 10 patients were found to have adenomatoid tumors(AT) 2 patients have rhabdomyosarcoma(RMS), and 1 patient angiomyxoma(AM). Conclusion:The differential diagnosis of whether intrascrotal masses are originating from testicular tissues or paratesticular structures is usually cannot be made. Therefore, radical orchiectomy is performed in the same way as testicular tumors and a definite diagnosis can be made by pathological examination. The paratesticular masses, 2-3% of the scrotal masses, should be considered in the differential diagnosis. In this regard, there is a need for studies with a higher number of series.

Ectopic ureter is a rare urological anomaly and is caused by developmental defect of the mesonephric canal and ureter bud in the embryonal period. It is frequently seen with anomalies such as double collecting system and dysplastic kidney. The treatment of this condition, which is more common in women than in men, varies according to the location of the accompanying pathologies, renal function, and ectopic ureter orifice. In this article, we discussed the clinical approach of the patient who presented to our clinic with painful macroscopic hematuria, dysuria, difficulty in urination, and an ectopic ureter opening to the prostatic urethra and accompanying distal ureteral calculi.