Search

Purpose: Neurogenic detrusor overactivity (NDOA) is characterized by involuntary detrusor muscle contractions during bladder filling in patients with neurological disorders. Anticholinergic therapy is the primary treatment; however, the reasons for treatment resistance in NDOA are not well understood. This study aimed to identify predictors of treatment failure by comparing urodynamic and frequency-volume chart data between patients with NDOA who respond and patients who do not respond to anticholinergic therapy. Methods: We reviewed the records of 362 patients presenting with lower urinary tract symptoms and selected 85 who had NDOA and were on anticholinergic therapy. Ultimately, 67 patients were analyzed. We categorized these individuals into responders (group R) and nonresponders (group NR) based on clinical and urodynamic improvements. Three-day frequencyvolume charts and urodynamic study results were retrospectively reviewed. Results: Of the 85 initial patients, 12 refused medication, and 6 were lost to follow-up. Pre- to posttreatment changes differed significantly between groups in the number of urgency urinary incontinence (UUI) episodes per 24 hours (P=0.001), maximum cystometric capacity (mL, P=0.003), NDOA frequency (P=0.004), and bladder compliance (mL/cm H2O, P=0.003). Multivariate analysis revealed that NDOA frequency (P=0.014) and UUI episodes per 24 hours (P=0.002) were significant factors associated with treatment failure. Conclusions: NDOA varies according to underlying neurological conditions. The frequencies of UUI episodes and NDOA in urodynamic studies can predict resistance to initial anticholinergic treatment. [ABSTRACT FROM AUTHOR]

Objective: For early diagnosis, testicular self-examination (TSE) is crucial. Videos of TSE have increased on social media platforms. In this study, we assessed the reliability of TSE videos on YouTube. Materials and Methods: The keywords including "testicular self-examination", and "testis mass" were used for searching on YouTube (http://www.youtube.com). A total of 1311 videos were investigated, and a total of 207 videos were included in the study. Shorter videos (below 1.30 minutes) and irrelevant videos were not included in the study. Results: The median number of views was 1846 (interquartile range: 406-30310). Most of the videos were uploaded by profit organizations (57.5%). The DISCERN score and Global Quality Score (GQS) were significantly higher in the health professional group (p=0.003, and p<0.001, respectively). In addition, the degree of information was generally low in both groups. However, misinformation was statistically lower in the health professional group. Conclusion: YouTube is a popular platform for promoting videos about TSE. In particular, not checking health-related videos while uploading causes poor quality videos to be uploaded. Videos of TSE have a low degree of misinformation. However, the DISCERN and GQS were also low. [ABSTRACT FROM AUTHOR]

Copyright of Konuralp Medical Journal / Konuralp Tip Dergisi is the property of Duzce University Medical School and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acibadem Saglik Bilimleri Dergisi is the property of Acibadem University Medical School and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Voiding dysfunction is a commonly encountered problem in children. If a patient has a history of urinary tract infection (UTI) and presents with fever, voiding cystourethrography (VCUG) is frequently used. Proximal urethra dilatation in VCUG was determined to be an indication of voiding dysfunction. Studies in literature have been the ones assessing the correlation between the presence of proximal urethra dilatation and voiding dysfunction. In our study, however, we analyzed the relationship between the proximal urethra diameter determined in VCUG of children with voiding dysfunction, the severity of the disease, the presence of reflux, and uroflowmetry parameters. Materials and Methods: Of the 522 VCUG-received patients 96 between the ages of 6-8 with voiding dysfunction concomitant with febrile UTI were evaluated. Dysfunctional voiding incontinence scoring (DVIS), uroflowmetry parameters, post-void residual measurements (PVR), proximal urethra diameter noted in VCUG, and presence of reflux in the patients were analysed. Results: The mean age was 7.2±0.66. The average proximal urethra diameter was 7.6±1.8 mm. Regarding the diameter, the patients were divided into two groups: Group 1 (7.6 mm and below) and group 2 (above 7.6 mm). DVIS was higher but vesicoureteral reflux (VUR) was lower in group 2 (p=0.017, p=0.008; respectively). For uroflowmetry parameters and PVR, no significant differences were noted. Conclusion: In the group with the high-proximal urethra diameter, DVIS was observed to be high. However, a negative correlation was determined between high-proximal urethra diameter and VUR. [ABSTRACT FROM AUTHOR]

Objective: Voiding dysfunction (VD), which encompasses many urinary symptoms that are not caused by neurological or anatomical anomalies, is a frequently encountered functional urinary bladder disorder in children. It was reported that there was an association between lower urinary tract symptoms and fecal microbiota in adult patients. Therefore, we aimed to investigate the differences in fecal microbiota between children with or without VD. Methods: Two patient groups, including 30 patients, were compared. Group 1 included patients with VD, while Group 2 consisted of healthy children. All study participants were asked to fill lower urinary tract and voiding dysfunction symptom score forms with the assistance of their parents. Subsequently, uroflowmetry tests and postvoiding residual urine measurements were performed. Fresh stool samples were collected from all children and analyzed by polymerase chain reaction. General bacterial load and presence of Roseburia intestinalis, Clostridium difficile, Fusobacterium nucleatum, and Bacteroides clarus were tested. Results: The two groups were significantly different regarding general bacterial load; the presence of Fusobacterium nucleatum. Clostridium difficile and Bacteroides clarus was not detected in the fresh stool samples of the patients in Group 2; the counts of Roseburia intestinalis were less in Group 1 than in Group 2, although there was no statistically significant difference. There was a negative correlation between symptom scores, general bacterial load, and the presence of Fusobacterium nucleatum. However, there was no correlation between the presence of Roseburia intestinalis and symptom scores. Conclusions: There is a potential relationship between VD and a deviation in the fecal microbiota in the pediatric population. [ABSTRACT FROM AUTHOR]

Introduction: Following the COVID‐19 pandemic, the face‐to‐face meetings are delayed to a future date, which is still not clear. However, seminars, meetings and conferences are necessary for updating our knowledge and skills. Web‐based seminars (webinars) are the solutions to this issue. This study aimed to show the participant behaviour when webinars present at the COVID‐19 pandemic era. Methods: From December 2017 to July 2020, 58 webinars were broadcasted via the Uropedia, electronic library of SUST. Data of all webinars were collected with the YouTube analytics and application of the Uropedia. Data of streaming webinars included participant behaviours such as content views, engagement time, total unique attendees, average engagement time and the number of audience to leads. Data were split into two groups; group‐1 is webinars before COVID‐19 (before March 2020) and group‐2 is the webinars during COVID‐19. Results: Total broadcast time and total page view number were found to be 112.6 hours (6761 minutes) and 15 919, respectively. The median participant age was 40.1 y. Median content view and median engagement time were found to be 261.0 and 12.2 minutes, respectively. Comparison of two groups revealed a significant increment in the content views (group‐1; 134.0 range = 86.0‐87.0 and group‐2; 414.0 range = 296.0‐602.0, P <.001) and the number of the unique attendees (group 1; 18.0 range = 10.0‐26.0 and group‐2; 57.0 range = 27.0‐100.0, P <.001) following COVID‐19. However, the median engagement time of the audience did not seem to change with the COVID‐19 pandemic (group‐1; 11.5 range = 10.0‐13.3 minutes and group‐2; 13.2 range = 9.4‐18.1 minutes, P =.12). Conclusion: The webinars are effective ways to share information and have many advantages, including low cost, reaching a high number of audiences. Audience number and page visits seemed to increase following the COVID‐19 pandemic. However, this era did not seem to affect the critical attitude of the audience, which is engagement time. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Reconstructive Urology is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: This study aimed to analyze the efficacy and safety of the percutaneous nephrolithotomy procedure in octogenarians and compare them with the outcomes in a young patient group. Materials and Methods: Patients older than 80 and younger than 90 were included in Group 1, and patients younger than 65 were assigned to Group 2. Group 1 included 45 patients, and Group 2 consisted of 90 patients recruited by one-to-two case-control matching based on gender, stone area, and the number of staghorn stones. Results: The mean patient age was 81.89 ± 1.70 and 38.7 ± 12.5 years in Groups 1 and 2, respectively. The patients in Group 1 had a significantly higher rate of systemic hypertension. Pre-operative and post-operative serum creatinine levels were higher in Group 1 than in Group 2. The groups did not differ in terms of the preoperative serum hemoglobin level. However, the postoperative serum hemoglobin level was significantly lower in Group 1. There was no difference between the two groups in terms of the rate of blood transfusions. The duration of hospital stay was significantly longer in Group 1. However, the two groups were not different in terms of minor and major complications. The stone-free rates were calculated as 73.3% and 77.8% in Groups 1 and 2, respectively. There was no difference between the groups in terms of stone-free rates (p = 0.567). Conclusion: The percutaneous nephrolithotomy procedure is an effective and safe method for treating renal stone disease in octogenarians. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to evaluate the performance of urine strip analysis for predicting manual microscopic urine analysis. Methods: Urine samples, which were ordered from patients with suspected urinary tract infection (UTI), and which were analyzed with both microscopic and strip analysis, were included in the study. Sensitivity, specificity, positive and negative likelihood ratios (LR +, LR-), pre- and post-test odds and post-test probability for cut-off values of "trace", "1+", "2+", "3+" of erythrocyte-strip (Eryth-S) and leucocyte-strip (Leuc-S) tests were calculated. Bayes theorem was used to determine conditional probability. Area under curve (AUC) of ROC was calculated. Results: The AUC for Leuc-S and Eryth-S was 0.923 and 0.975, respectively. The Leuc-S test in "1+" and Eryth-S test in "trace" cut-off value had adequate sensitivity and specificity (>80%). Leuc-S of "3+" and Eryth-S of all cut-off values for LR+ value; Leuc-S of "trace" and Eryth-S of "trace" and "1+" for LR- value were significantly different for posttest probability(<0,1). Periodic pre-test probability rate of UTI was calculated as 5.95%. According to the microscopic analysis, the post-test probability of UTI was 39% for Leuc-S "3+" and 74% for Eryth-S "3+". Conclusion: The urine strip analysis was found to be sufficient in predicting the positivity of leukocytes and erythrocytes in manual microscopic analysis. The diagnostic accuracy differs according to the estimation values in the urine strip analysis. We think that our study will provide awareness on this issue and will have an impact on determining test requests of physicians in patients with UTI and preventing unnecessary test requests. [ABSTRACT FROM AUTHOR]

OBJECTIVE To evaluate the perspectives of radiation oncologists (ROs), medical oncologists (MOs) and urologists (UROs) towards active surveillance (AS) in the management of prostate cancer (PCa). METHODS A questionnaire with total of 24 questions was sent out via e-mail to the physicians. 244 participants completed the questionnaire. Pearson Chi square test and multivariable logistic regression models were used to identify physicians' characteristics and attitudes about AS. RESULTS There were 129 UROs (52.9%), 76 ROs (31.1%) and 39 MOs (16%) in the study population. The analysis of the important factors while considering AS showed that prostate cancer risk group (85.7%) was the most commonly considered criteria, followed by patient's request and compliance (84.8%), life expectancy (76.2%) and sexual activity of the patient (34.8%). The AS was recommended by 86.8% of UROs, 77.6% of ROs and 61.6% of MOs (p=0.002). In multivariate analysis, practicing as ROs (p=0.031) or UROs (p<0.001), working in a reference hospital (p=0.006) and having an uro-oncology board (p=0.031) were found to be associated with more recommendations for AS. CONCLUSION More clinical experience and multi-disciplinary approach were associated with tendency of recommending AS. Educational sessions and uro-oncology board discussions may provide more integration of AS to our clinical practice routines. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Urological Surgery is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The primary outcome of this study is to compare the success rates of ONB techniques performed either with ultrasound guidance or with the blind technique. The second outcome is to compare the incidences of perioperative bleeding and the presence of recurrent tumors in the control cystoscopy performed in the 3rd postoperative month in both groups. Materials and Methods: The study was conducted in the urology operating room of Mugla Sitki Kocman Training and Research Hospital between December 2019 and March 2023. A total of 122 patients were included in the study: 22 females with a mean age of 56.63 ± 12.99 years and 100 males with a mean age of 63.18 ± 8.00 years. In one group (group 1), ONB was performed under ultrasound guidance by the same anesthesiologist, and in another group (group 2), ONB was performed blindly based on anatomical signs by the same urologist. Results: Adductor muscle contraction was not observed in 53 patients (91.4%) in group 1 and in 49 patients (76.6%) in group 2 (p = 0.027). Conclusion: The success rate of ONB was higher when using an ultrasound-guided technique than when using a blind technique. [ABSTRACT FROM AUTHOR]

Objective: To analyze factors influencing reflux resolution in patients with the coexistence of non‐neurogenic lower urinary tract dysfunction and vesicoureteral reflux. Methods: The data of 153 children who were diagnosed with vesicoureteral reflux and accompanying non‐neurogenic lower urinary tract dysfunction between 2010 and 2015 were retrospectively evaluated. Patients with neurogenic and anatomical malformations, monosymptomatic nocturnal enuresis, previous history of vesicoureteral reflux surgery, irregular and/or incomplete follow‐up data were excluded. After exclusion of 55 patients, 98 patients were enrolled in this study. Patients were divided into two groups according to the presence of spontaneous vesicoureteral reflux resolution during the follow‐up period. Group 1 consisted of 54 children with spontaneous vesicoureteral reflux resolution, whereas group 2 included 44 children without resolution. Medical history, physical examination, urinalysis, uroflowmetry combined with electromyography, ultrasonography, as well as the Dysfunctional Voiding and Incontinence Symptom Score questionnaire were also evaluated. Results: The mean age at presentation was 7.57 ± 0.23 years (range 5–13 years), and the mean follow‐up period was 28.3 months. Significant differences were noted between the two groups in terms of dysfunctional voiding and incontinence symptom score, bladder wall thickness, and the post‐void residual urine volumes. In addition, lower urinary tract symptoms, namely frequency, urgency and daytime incontinence, were found to be higher in group 2. In multivariate analysis, post‐void residual urine volume and Dysfunctional Voiding and Incontinence Symptom Score were found to affect reflux resolution rates (P = 0.002, P = 0.002, respectively). Conclusions: The absence of significant post‐void residual urine volume, and a low Dysfunctional Voiding and Incontinence Symptom Score increase the likelihood of spontaneous resolution rates of vesicoureteral reflux in children with non‐neurogenic lower urinary tract dysfunction. [ABSTRACT FROM AUTHOR]

We compare the efficacy of intratesticular ozone therapy with intraperitoneal ozone therapy in an experimental rat model. For this purpose, 24 rats were divided into four groups including sham-operated, torsion/detorsion, torsion/detorsion plus intraperitoneal ozone (O-IP), and torsion/detorsion plus intratesticular ozone (O-IT). The O-IP ozone group received a 4 mg kg−1 intraperitoneal injection of ozone, and the O-IT group received the same injection epididymally. At 4 h after detorsion, the rats were sacrificed and orchiectomy materials were assessed histopathologically. Spermatogenesis in the seminiferous tubules and damage to the Sertoli cells were histopathologically evaluated in the testes using the Johnsen scoring system. i-NOS and e-NOS activities in the testis tissue were also evaluated. Torsion-detorsion caused a decreased Johnsen score and increased apoptosis of spermatogonial and Sertoli cells. Ozone injection prevented increases in Johnsen score and i-NOS level. e-NOS level of the O-IP group was significantly lower than that of the O-IP group, and i-NOS level of the O-IT group was significantly lower than that of the O-IP group. Local ozone therapy is more effective than systemic ozone therapy at improving IRI-related testicular torsion. Our study is the first to show that the efficacy of intratesticular implementation of ozone therapy is higher than that of intraperitoneal ozone therapy. [ABSTRACT FROM AUTHOR]

Splenogonadal fusion, which can be clinically confused with testicular neoplasms as they present with testicular swelling, is a rare abnormality in young adults. Intraoperative frozen section analysis can be helpful in diagnosing such cases and preventing unnecessary orchiectomies. We report a case in which frozen section analysis was done and testis-sparing surgery could be performed. [ABSTRACT FROM AUTHOR]

To determine toilet training age and the factors influencing this in our country, 1500 children who had completed toilet training were evaluated in a multicenter study. The mean age of toilet training was 2 2 . 3 2 ± 6 . 5 7 months. The duration it took to complete toilet training was 6 . 6 0 + 2 . 2 0 months on the average. In univariant analysis, toilet training age increased as the parental education level, specifically that of the mother, increased. The training age of children whose mothers had over 12 years of education differed significantly from that of children of mothers with less education. There was no significant difference in toilet training age with regard to the education level of the father, or the employment status of the mother. We also found significant differences with respect to family income level, toilet type and training method. In multivariant analysis, family income > 5 0 0 0 TL and use of a potty chair were determined to be factors affecting toilet training age. In conclusion, toilet training age in Turkey, a developing country, was found to be lower than that in developed countries. [ABSTRACT FROM AUTHOR]

Erectile dysfunction (ED) is the inability to develop normal erection or an hardening problem at various extent that causes inability to maintain the erection for the sufficient time required for a complete sexual activity. It can be the result of neurologic, psychogenic, vascular, urogenital and hormonal abnormalities. It is reported that it affects 52-67% of men between 40 and 70 years old. Numerous theories and opinions are issued in the literature in order to explain the hemodynamic changed that occur during erection and detumescence. Especially the effects of chronic diseases and psychogenic factors on the pathophysiology of erectile dysfunction are common matters of discussion in recent years. In this review, we will evaluate the current developments in the literature about the etiology of erectile dysfunction. [ABSTRACT FROM AUTHOR]

Objective. The etiology of premature ejaculation (PE) is unknown. Over the past two decades several studies have suggested that lifelong and acquired PE may be caused by somatic disorders and/or neurobiological disturbances. One controversial factor is the effect of circumcision on ejaculation. This prospective study investigated the relationship between postcircumcision penile mucosal cuff length, circumcision scar thickness and the PE syndromes. Features of PE patients were compared with those of a normal healthy control (NHC) group. Material and methods. In total, 160 circumcised men were studied: 80 men with PE and 80 men in the NHC group. The following data and measurements were evaluated: age, type of PE syndrome, intravaginal ejaculation latency time (IELT), circumcision scar thickness and postcircumcision mucosal cuff length. Results. In terms of the mean IELT, a statistically significant difference was detected between the PE syndromes (p < 0.05), and between the PE patients and the control group (p < 0.05). Among the four PE syndromes, there was no significant difference related to the mean mucosal cuff length and mean circumcision scar thickness (p > 0.05). No significant difference was observed between the two groups for mean mucosal cuff length (p > 0.05) or mean circumcision scar thickness (p > 0.05). Conclusion. In this study, no relationship was observed between PE and postcircumcision penile mucosal cuff length and circumcision scar thickness. Further studies are required to evaluate the positive and negative effects of circumcision on PE syndromes. [ABSTRACT FROM AUTHOR]

Response to Re: Can we predict vesicoureteral reflux resolution in patients with non-neurogenic lower urinary tract dysfunction? Keywords: non-neurogenic lower urinary tract dysfunction; spontaneous reflux resolution; vesicoureteral reflux; voiding cystourethrogram EN non-neurogenic lower urinary tract dysfunction spontaneous reflux resolution vesicoureteral reflux voiding cystourethrogram 180 180 1 02/07/22 20220201 NES 220201 We thank Selvi and Baydilli for their thoughtful review and comments on our article.1 Although some previous studies showed that high-grade vesicoureteral reflux (VUR) was associated with a lower likelihood of spontaneous resolution2,3 other factors, such as female sex, older age bladder dysfunction, breakthrough infections and early reflux during bladder filling, were identified as predictors of resolution.4,5 As Selvi and Baydilli stated, the grade of the VUR did not contribute to the spontaneous resolution in our multivariate analysis. Spontaneous reflux resolution, voiding cystourethrogram, non-neurogenic lower urinary tract dysfunction, vesicoureteral reflux. [Extracted from the article]

Urothelial bladder carcinoma is a rare condition in young patients. Clinicians have less inclination to perform cystoscopy in this age group because benign causes of hematuria are more common. Thus, diagnostic delays of up to one year may occur. We report a 24-year-old male patient with urothelial bladder cancer. Clinical behavior and prognosis in young individuals are controversial. The definitions of "young patient" are highly variable and different World Health Organization pathological classification systems are used for reporting. Generally, it presents as a low-stage and low-grade disease, nevertheless, it may present with high-grade tumors, even with muscle-invasive cancer. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to investigate gender-specific differences in the Turkish patients with renal cell carcinoma (RCC) undergoing radical or nephron-sparing nephrectomy and compare the results with those in other regions. Materials and Methods: Data of 76 patients, who were clinically diagnosed with RCC and underwent radical or nephron-sparing nephrectomy from January 2011 to August 2017, were retrospectively evaluated. Age and gender of the patients and the size, histological type, grade and pathological stage of the tumors were recorded. A chi-square test was used for comparing categorical variables, whereas the Student's t-test was used for the same purpose in the continuous variables. Results: Of the 67 patients, 39 (58.2%) were male and 28 (41.8%) were female; male-to-female ratio was 3:2. The mean age of the male and female patients was 63.4±11.7 years and 59.3±14.3 years, respectively and the mean tumor size was 5.7 and 5.3 cm, respectively. There were differences in mean age, tumor size and Fuhrman grade, however, none of them reached the level of statistical significance. Twenty four of the male and 25 of the female patients had low-stage, 15 of the male and 3 of the female patients had high-stage disease. Thus, the male patients had higher stage disease than the female patients and the difference was statistically significant (p=0.011). Conclusion: Turkish women with RCC had significantly lower stage disease than Turkish men, although grade and size of the tumor did not present a statistically significant difference. The results were similar with other European studies. [ABSTRACT FROM AUTHOR]

Primary signet cell carcinoma of the prostate is a rare histological variant of prostate malignancies. It is commonly originated from the stomach, colon, pancreas, and less commonly in the bladder. Prognosis of the classical type is worse than the adenocarcinoma of the prostate. Primary signet cell adenocarcinoma is diagnosed by eliminating the adenocarcinomas of other organs such as gastrointestinal tract organs. In this case report, we present a case with primary signet cell adenocarcinoma of the prostate who received docetaxel chemotherapy because of short prostate specific antigen doubling time. [ABSTRACT FROM AUTHOR]

Purpose: To examine the effect of routine sampling anterior apical cores in the initial prostate biopsy among patients that 14-cores of prostate biopsy (PB) planned. Materials and Methods: Five-hundred twenty-eight patients with increased prostate-specific antigen (PSA) levels and/or abnormal digital rectal examination underwent transrectal ultrasound and initial PB between November 2012 and October 2013. We performed routine 12-cores extended PB, plus 2 anterior apex samples that were taken from the junction of urethra and apex of the prostate. Site-specific and unique cancer detection rate, tumor characteristics, the presence of clinically insignificant prostate cancer (PCa) (clinical stage ≤ T1, serum PSA level of < 10 ng/mL, biopsy Gleason score ≤ 6, number of positive biopsy cores = 3 and no core with > 50% involvement) and biopsy-related pain were evaluated. Results: PCa was detected in 147 of 451 patients (32.6%). The lateral base of the prostate was the most affected area with 128 of 451 patients (28.3%), followed by unique cancer detection, with 17 of 40 patients (43.5%). Anterior apex (n = 6) was in third place after the lateral apex (n = 8). The patients diagnosed by anterior apex cores were all clinically insignificant PCa. The cancer diagnosis rate would be 31% if 12-cores biopsy was used, but the rate was found to be 32.6% in 14-cores biopsy (P = .016). Average biopsy pain, right anterior apex biopsy pain, and left anterior apex biopsy pain were found to register at 0.61, 1.06 and 1.08 points in the visual analog scale pain score, respectively. When right and left anterior apex biopsy pain is compared to average biopsy pain, the pain level was found to be statistically significantly higher in the biopsies of right and left anterior apex (P = .040 and P = .042, respectively). Conclusion: The gold standard for the diagnosis of PCa is at least 8 cores PB. According to our results, although most PCa diagnosis is carried out with 14-cores PB, it should not be forgotten that these patients might have clinically insignificant PCa. [ABSTRACT FROM AUTHOR]

Introduction: Obesity has been suggested to lower the success of percutaneous nephrolithotomy (PCNL). However, the relationship between abdominal fat parameters, such as visceral and subcutaneous abdominal adipose tissue, and PCNL success remained unclear. In this study, we aimed to investigate the effect of abdominal fat parameters on PCNL success. Methods: A total of 150 patients who underwent PCNL were retrospectively enrolled in this study. Group 1 consisted of patients who had no residual stones or residual stone fragments <3 mm in diameter while group 2 included patients with residual stone fragments ⩾3 mm. PCNL procedure was defined as successful if all stones were eliminated or if there were residual stone fragments <3 mm in diameter confirmed by non-contrast computed tomography (NCCT) performed postoperatively. Preoperative NCCT was used to determine abdominal fat parameters. Results: Group 1 consisted of 117 (78.0%) patients while group 2 included 33 (22.0%) patients. On univariate analysis, stone number, stone surface area (SSA), visceral fat area (VFA), abdominal circumference on computerized tomography (ACCT), and duration of procedure were found to be predictive factors affecting PCNL success. Logistic regression analysis revealed that ACCT and SSA were independent prognostic factors for PCNL success. Conclusions: PCNL success was not affected by VFA, subcutaneous fat area (SFA) and body mass index (BMI) in our series. However, ACCT and SSA had negative associations with PCNL success. We conclude that both ACCT and SSA can be used as tools for predicting PCNL outcomes. [ABSTRACT FROM AUTHOR]

Objective: To present a nation-wide analysis of the workload of urology departments in Turkey week-by-week during Covid-19 pandemic., Methodology: The centres participating in the study were divided into three groups as tertiary referral centres, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9-March-2020 and 31-May-2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated, also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019., Results: A total of 51 centres participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the 3rd week of pandemics in state hospitals and tertiary referral centres; however, the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared, a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid-19 pandemic compared with normal life., Conclusions: Covid-19 pandemic significantly affected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non-deferrable surgeries by urologists in concordance with published clinical guidelines., (© 2020 John Wiley & Sons Ltd.)

Introduction: We examined the relationship between stone disease and the amount of visceral adipose tissue measured with unenhanced computed tomography (CT)., Methods: We included 149 patients with complaints of flank pain and kidney stones detected by CT, from August 2012 to April 2013. In addition, as the control group we included 139 healthy individuals, with flank pain within the same time period, with no previous history of urological disease and no current kidney stones identified by CT. Patients were analyzed for age, gender, body mass index, amount of visceral and subcutaneous adipose tissue, and serum level of low-density lipoprotein and triglyceride., Results: There were no differences between groups in terms of gender and age (p = 0.27 and 0.06, respectively). Respective measurements for the stone and control groups for body mass index were 29.1 and 27.6 kg/m(2); for visceral fat measurement 186.0 and 120.2 cm(2); and for subcutaneous fat measurements 275.9 and 261.9 cm(2) (p = 0.01; 0.01 and 0.36, respectively). Using multivariate analysis, the following factors were identified as increasing the risk of kidney stone formation: hyperlipidemia (p = 0.003), hypertension (p = 0.001), and ratio of visceral fat tissue to subcutaneous fat tissue (p = 0.01). Our study has its limitations, including its retrospective nature, its small sample size, possible selection bias, and missing data. The lack of stone composition data is another major limitation of our study., Conclusion: The ratio of visceral to subcutaneous adipose tissue, in addition to obesity, hyperlipidemia, and hypertension, was identified as an emerging factor in the formation of kidney stones.

Introduction: Patients with high-risk non-muscle invasive bladder cancer (NMIBC) need adjuvant intravesical treatment after surgery. Although bacillus Calmette-Guérin (BCG) is highly effective, new adjuvant treatments to decrease recurrences and toxicity have been studies. We performed a retrospective propensity score-matched study to compare the efficacy of BCG and chemohyperthermia (C-HT)., Methods: We included 1937 patients diagnosed with bladder cancer between January 2004 and January 2014. The primary efficacy endpoint was recurrence-free interval. Patients treated with C-HT were matched with patients treated with BCG using propensity score-matched analysis. Cox-regression models were used to estimate the association between intravesical treatments and the presence of recurrence and progression., Results: Of the 710 patients treated with intravesical treatments, 40 and 142 were eligible for inclusion in C-HT and BCG groups, respectively. Following case matching, there were no differences in patient or tumour characteristics between treatment groups. The 2-year recurrence-free interval in C-HT and BCG groups were 76.2% and 93.9%, respectively (p = 0.020). C-HT treatment (hazard ratio [HR] 5.42; 95% confidence interval [CI] 1.11-26.43; p = 0.036) and high-grade tumour (HR 4.60; 95% CI 1.01-20.88; p = 0.048) are associated with an elevated odds of tumour recurrence. In multivariate Cox-regression analysis, there was no significant difference between C-HT and BCG in the odds of recurrence (p = 0.054). There were no differences in progression between C-HT and BCG., Conclusion: C-HT is not as effective treatment as BCG in high-risk NMIBC patients who are BCG-naive. Although, there were no significant difference in the odds of recurrence, recurrence-free interval is significantly improved by the administration of BCG.

Purpose: To examine the effect of routine sampling anterior apical cores in the initial prostate biopsy among patients that 14-cores of prostate biopsy (PB) planned., Materials and Methods: Five-hundred twenty-eight patients with increased prostate-specific antigen (PSA) levels and/or abnormal digital rectal examination underwent transrectal ultrasound and initial PB between November 2012 and October 2013. We performed routine 12-cores extended PB, plus 2 anterior apex samples that were taken from the junction of urethra and apex of the prostate. Site-specific and unique cancer detection rate, tumor characteristics, the presence of clinically insignificant prostate cancer (PCa) (clinical stage ≤ T1, serum PSA level of < 10 ng/mL, biopsy Gleason score ≤ 6, number of positive biopsy cores ≤ 3 and no core with > 50% involvement) and biopsy-related pain were evaluated., Results: PCa was detected in 147 of 451 patients (32.6%). The lateral base of the prostate was the most affected area with 128 of 451 patients (28.3%), followed by unique cancer detection, with 17 of 40 patients (43.5%). Anterior apex (n = 6) was in third place after the lateral apex (n = 8). The patients diagnosed by anterior apex cores were all clinically insignificant PCa. The cancer diagnosis rate would be 31% if 12-cores biopsy was used, but the rate was found to be 32.6% in 14-cores biopsy (P = .016). Average biopsy pain, right anterior apex biopsy pain, and left anterior apex biopsy pain were found to register at 0.61, 1.06 and 1.08 points in the visual analog scale pain score, respectively. When right and left anterior apex biopsy pain is compared to average biopsy pain, the pain level was found to be statistically significantly higher in the biopsies of right and left anterior apex (P = .040 and P = .042, respectively)., Conclusion: The gold standard for the diagnosis of PCa is at least 8 cores PB. According to our results, although most PCa diagnosis is carried out with 14-cores PB, it should not be forgotten that these patients might have clinically insignificant PCa.

Purpose: To examine the effectiveness of mitomycin-C and chemo-hyperthermia in combination for patients with high-risk non-muscle-invasive bladder cancer., Materials and Methods: Between November 2011-September 2013, 43 patients with high-risk non-muscle-invasive bladder cancer undergoing adjuvant chemo-hyperthermia in two centers were evaluated retrospectively. Treatment consisted of 6 weekly sessions, followed by 6 sessions. Recurrence and progression rate, recurrence-free interval and side effects were examined. Analyzed factors included age, gender, smoking status, AB0 blood group, body mass index, T stage and grade, concominant CIS assets. The associations between predictors and recurrence were assessed using multivariate Cox proportional hazard analyses., Results: A total of 40 patients completed induction therapy. Thirteen (32.5%) were diagnosed with tumor recurrence. Median follow-up was 30 months (range 9-39). Median recurrence-free survival was 23 months (range 6-36). The Kaplan-Meier-estimated recurrence-free rates for the entire group at 12 and 24 months were 82% and 61%. There was no statistically significant difference between patient subgroups. Cox hazard analyses showed that an A blood type (OR=6.23, p=0.031) was an independent predictor of recurrence- free. Adverse effects were seen in 53% of patients and these were frequently grades 1 and 2., Conclusions: Intravesical therapy with combination of mitomycin-C and chemohyperthermia seems to be appropriate in high-risk patients with non-muscle-invasive bladder cancer who cannot tolerate or have contraindications for standard BCG therapy.

Introduction: We assess the effect of video-based education on patient anxiety during transrectal prostate biopsy., Methods: A total of 246 patients who underwent transrectal prostate biopsy were prospectively enrolled in the study. Group 1 included 123 patients who received both written and video-based education, while Group 2 included 123 patients who received only written instructions regarding prostate biopsies. State-Trait Anxiety Inventory (STAI) was used to assess state and trait anxiety (STAI-S/T) After completing the STAI-S and STAI-T questionnaires, all patients in Group 1 received written information and video-based education and they again completed STAI-S before the biopsy. On the contrary, after completing the STAI-S and STAI-T questionnaires, the patients in Group 2 received only written information and then they completed the STAI-S before the biopsy. Moreover, a visual analog scale (VAS) was used to assess pain scores during digital rectal examination, probe insertion, periprostatic local anesthesic infiltration, and biopsy., Results: No difference was noted between 2 groups regarding VAS scores. Comparing the 2 groups on baseline anxiety, we found that trait anxiety scores (STAI-T) were similar (p = 0.238). Pre-information STAI-S scores were similar in both groups (p = 0.889) and they both indicated high anxiety levels (score ≥42). While post-information STAI-S scores remained high in Group 2, post-information STAI-S scores significantly decreased in Group 1 (p = 0.01)., Conclusions: Undergoing a prostate biopsy is stressful and may cause anxiety for patients. Video-based education about the procedure can diminish patient anxiety.

Erectile dysfunction (ED) is the inability to develop normal erection or an hardening problem at various extent that causes inability to maintain the erection for the sufficient time required for a complete sexual activity. It can be the result of neurologic, psychogenic, vascular, urogenital and hormonal abnormalities. It is reported that it affects 52-67% of men between 40 and 70 years old. Numerous theories and opinions are issued in the literature in order to explain the hemodynamic changea that occur during erection and detumescence. Especially the effects of chronic diseases and psychogenic factors on the pathophysiology of erectile dysfunction are common matters of discussion in recent years. In this review, we will evaluate the current developments in the literature about the etiology of erectile dysfunction.

Primary signet cell carcinoma of the prostate is a rare histological variant of prostate malignancies. It is commonly originated from the stomach, colon, pancreas, and less commonly in the bladder. Prognosis of the classical type is worse than the adenocarcinoma of the prostate. Primary signet cell adenocarcinoma is diagnosed by eliminating the adenocarcinomas of other organs such as gastrointestinal tract organs. In this case report, we present a case with primary signet cell adenocarcinoma of the prostate who received docetaxel chemotherapy because of short prostate specific antigen doubling time.

Purpose: In this study, we evaluated the effect of preputial type on bacterial colonization and wound healing in boys undergoing circumcision., Materials and Methods: This study consisted of 78 boys consecutively admitted to our clinic for circumcision between 2009 and 2011. Preputial status was classified into five types on the basis of preputial retractability. One sterile culture swab was swept circumferentially once around the surface of the glans starting just proximal to the urethral meatus. Three weeks following circumcision, control swabs from the same regions of the same patients were taken and inoculated. Thus, the same patients formed the control group. Patients were evaluated on days 1 and 7 after the operation to assess whether the preputial type affected healing., Results: The mean age of the children was 46.3 months. In our study, the growth rate was 71.8% in pre-circumcision patients, whereas the rate was 10.25% in the post-circumcision group. Types 1, 2, 3, 4, and 5 had 100%, 93.8%, 71.4%, 44.4%, and 53.6% colonization, respectively. A significant difference was observed among these types in terms of colonization. The most common agent was Enterococcus species (33%). When postoperative patients were evaluated, all had local swelling and hyperemia on postoperative day 1, whereas there was a significant difference on day 7., Conclusions: There was a significant correlation between preputial type and bacterial colonization, and the preputial type affected post-circumcision wound healing. Practitioners should keep in mind that the healing period will be longer in patients with type 1, 2, and 3 preputium.

Fibrous pseudotumors of the tunica vaginalis, epididymis, and spermatic cord are uncommon benign paratesticular masses. We report the case of a 27-year-old man who presented with grossly abnormal testicular examination. Scrotal Doppler ultrasound scan showed normal testicles bilaterally and solid, round, multiple 15-40 mm hypoechoic lesions adjacent to the right testis. Tumoral markers were within normal limits. Uncomplicated right radical orchiectomy was performed. After a follow-up of 12 months, no relapse occurred. We discuss about rare benign paratesticular masses identified as fibrous pseudotumors.