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Introduction and Aim: Ureteroenteric anastomosis stricture (UEAS) is one of the complications of urinary diversion and may lead to serious consequences. In this study, we evaluated our UEAS revision technique outcomes performed with a low lombotomy incision in the lateral decubitus position.Materials and Methods: Eleven patients who underwent surgical repair due to isolated right UEAS between January 2010 and June 2019 were included in the study. Anastomosis stricture was confirmed by ultrasonography, computed tomography or magnetic resonance urography techniques. Ultrasonography was used to detect hydronephrosis, which is a finding secondary to stricture. However, opaque urography imaging methods were used to confirm the definitive diagnosis of the stricture. Demographic and clinical data, preoperative and postoperative 3rd month serum creatinine, estimated glomerular filtration rate (eGFR) and dynamic renal scintigraphy data of patients were evaluated.Results: The mean operation time was 49.7 ± 9.3 minutes. No perioperative complications were observed. While the overall stricture rate was 11.4%, the isolated right-sided stricture rate was 5.7%. Preoperative and postoperative serum creatinine values were similar. Preoperative eGFR value was 58.8 ± 12.9 mL/min/1.73 m2 and postoperative value was 53.5 ± 11.5 mL/min/1.73 m2 . T½ level decreased in postoperative period (22.3 ± 8.2 min vs 15.1 ± 4.3 min).Conclusions: Open revision of the UEAS with retroperitoneal approach provides lower morbidity rates and shorter hospitalisation time compared to other methods. The retroperitoneal approach is the main advantage of this technique and prevents morbidity caused by other techniques performed intraperitoneally and owing to it is an open technique, it can be easily applied in isolated right-sided UEAS. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to make a comprehensive comparison of the first hundred robot-assisted radical prostatectomy (RARP) and open retropubic radical prostatectomy (RRP) cases of a single surgeon in a high-volume center. Methods: Preoperative, perioperative and postoperative data were collected retrospectively. Perioperative, oncological data and functional results in the first year were compared between the two groups. There were 204 RARPs between January 1, 2014 and December 31, 2019, and 755 RRPs between April 1, 2007 and December 31, 2019. Results: While the operation time was in favor of the open group (117 vs 188 min, p<0.001), the estimated blood loss (328 vs 150 ml, p<0.001), blood transfusion rate (12 vs 2, p=0.021), and re-operation rate (6 vs 0, p=0.001) were in favor of the robotic group. Mean length of hospital stay (5.4 vs 3.1, p<0.001), urine leak rate (11 vs 2, p=0.033), complication rate (37 vs 16, p=0.018), and the 12th month continence rate (67 vs 85, p=0.002) were better in the robotic group. Conclusions: RARP may provide better perioperative outcomes and lower complication rates after the surgeon factor is eliminated in the early period. Since our case group includes the initial 100 patients, studies with larger patient groups with longer follow-up are needed to adapt these early results to general outcomes. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to investigate the effect of percutaneous nephrostomy (PCN) implementation on the second ureteroscopy (URS) outcomes after a failed URS. Materials and Methods: The data of four hundred forty-eight patients with an unsuccessful URS history were evaluated. Patients were divided into two groups; patients who underwent PCN before second URS (Group A) and patients who did not (Group B). We compared the stone access rate in the second URS between the two groups according to patient and stone characteristics and operative data. Then, group A was subdivided into two groups according to stone access as; access succeeded (Group A1) and access failed (Group A2). We also compared stone access rates between these two groups in terms of gender, age, body mass index, stone size, side, location, grade of hydronephrosis and PCN duration. All data were available immediately after surgery and obtained from patient files and the outcome assessment was performed during the study period. Results: Stone access rate was higher in group A than group B (143/196 vs 41/252, P = .0018). Mean nephrostomy duration and mean hydronephrosis grade were significantly higher and mean stone size was significantly lower in group A1 than group A2 (18.74 vs 9.62 days, P < .001; grade 3.25 vs 1.21, P = .038; and 7.286 vs 12.631 mm P < .001, respectively). Conclusion: PCN is a favourable intervention after a failed URS and increases the success rate of the second operation with ease of implementation and minimal morbidity. [ABSTRACT FROM AUTHOR]

Objective: In the present study, we investigated the efficacy of bladder hydrodistension combined with pentosan polysulfate (PPS) treatment in interstitial cystitis (IC)/bladder pain syndrome (BPS). Methods: In this study, 339 patients diagnosed with IC/BPS were categorized into two groups. The first group only received 300 mg/day PPS, while the second group received 300 mg/day PPS following bladder hydrodistension. The results were evaluated at the 3rd, 6th, and 12th months after the first dose using the interstitial cystitis symptom index (ICSI), international cystitis problem index (ICPI), visual analog scale (VAS), and female sexual function index (FSFI). Results: PPS treatment started just after hydrodistension was significantly more effective than PPS treatment alone and combined treatment significantly reduced the rate of non-compliance such that, at the end of the 3rd month, 12.1% patients in Group-1 did not continue their treatment whereas only 1.9% of patients in Group-2 did not continue. Conclusions: The study results indicate that PPS treatment started just after hydrodistension yields significantly better results in terms of both symptom improvement and treatment compliance in patients with IC/BPS. [ABSTRACT FROM AUTHOR]

Aim: To determine the relationship between androgen receptor (AR) gene polymorphism and prostate cancer in our society. Materials and methods: Thirty-nine patients diagnosed with prostate cancer and 34 benign prostatic hyperplasia (BPH) patients who were diagnosed in 2010 met the study criteria. he inclusion criteria included patients whose diagnosis was confirmed with a biopsy, with the presence of adequate pathologic material for review, between the ages of 40 and 80, and who were healthy men without a family history of prostate cancer. The exclusion criteria excluded men diagnosed with another cancer and those who had kin with a history of prostate cancer. A direct DNA sequencing method was utilized for detection of polymorphisms. Results: CAG repeat length varied from 13 to 28 (mean: 21.67) for the BPH group and 12 to 28 (mean: 21.74) for the prostate cancer group. Prostate-specific antigen (PSA) density and the androgen receptor (AR) CAG repeat had a statistically significant negative correlation in the BPH group. A statistically significant difference was associated between AR CAG repeat and PSA density. Conclusion: Randomized prospective studies should be planned with larger patient and control groups and with more variables, which may open new horizons in prostate cancer screening and early detection. [ABSTRACT FROM AUTHOR]

Objective: Prostate biopsy for the diagnosis of prostate cancer by transrectal ultrasonography (TRUS) is a common procedure used in daily urology practice with a low complication rate and easy applicability. In this study, the precipitating factors and prophylaxis for sepsis, the worst complication of the procedure, were assessed. Patients and Methods: 2,023 patients with suspected prostate cancer who underwent biopsy by TRUS in one center were assessed retrospectively. The relationship between sepsis and age, serum total prostate-specific antigen (PSA) level, PSA density, prostate volume, number of biopsies, number of repeated biopsies, accompanying diagnosis of prostatitis, presence of urethral catheter, and presence of diabetes mellitus was assessed. Data were analyzed using the t test and logistic regression analysis. Results: Of the 2,023 patients, 62 (3.06%) developed sepsis within 5 days after biopsy. There was no significant relationship between the biopsy and the above parameters using the logistic regression analysis. Using the t test, it was found that the number of biopsy cores (p < 0.001), presence of urethral catheter (p < 0.0001), and presence of diabetes mellitus (p < 0.0001) were predictive factors for sepsis. Conclusion: Sepsis is a rare but life-threatening complication after prostate biopsy by TRUS. Although preoperative prophylactic oral antibiotics and enema before biopsy have proven to be effective in decreasing urinary tract infection rates, patients with urethral catheter, diabetes mellitus or those to undergo biopsy from more sites than ten cores should be closely monitored after biopsy. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Purpose: We aimed to investigate the histopathological correlation of the suspected prostate malignancy detected in multiparametric prostate magnetic resonance imaging (mpMRI).Materials and Methods: The data of 93 patients underwent radical prostatectomy and had preoperative mpMRI were examined. Age and pre-operative Prostate-Specific Antigen value were retrospectively collected from patient files. The pathology specimens were examined again and post-operative ISUP grade group, other pathological findings (seminal vesicle invasion, lymph node involvement and extraprostatic extension), pre-operative mpMRI were re-examined and PIRADS score, extracapsular extension, seminal vesicle invasion, neurovascular bundle invasion, lymph node involvement and ADC values were recorded.Results: 151 (92,07%) of 164 lesions detected in mpMRI were histopathologically correlated. 80% of patients with seminal vesicle invasion (P < 0.001), 28.8% of patients with extracapsular extension (P < 0.052) and 42.9% of patients with lymph node involvement (P = .001) in mpMRI were histopathologically correlated. A significant relationship was found between PIRADS scores and ISUP grade groups (P < 0.001). There was a negative correlation between ADC values and ISUP grade groups (P < 0.001).Conclusion: Our study showed that the lesions detected by mpMRI showed a high histopathological correlation. [ABSTRACT FROM AUTHOR]

Objective: Wound dehiscence is associated with high morbidity and mortality. This study aimed to analyze the risk factors and comorbidities in the patients undergoing radical cystectomy with early postoperative wound dehiscence., Methods: In all, 539 patients with bladder cancer who underwent radical cystectomy and urinary diversion at a single center between January 2008 and January 2022 were included in the study. The data related to the demographics, medical history, and perioperative clinical features were reviewed. Univariate and multivariate regression analysis was performed to identify risk factors for wound dehiscence., Results: The mean age of the patients was 64.2 years (22-91). The mean body mass index was 26.4 kg/m2 (18.7-35.4). Wound dehiscence was observed in 43 (7.9%) of 539 patients. The patients with wound dehiscence had significantly higher mean BMI (27.8 vs. 26.3, p=0.006), ASA scores (p=0.002), history of chronic obstructive pulmonary disease (30.2 vs. 14.3%, p=0.006), diabetes mellitus (44.2 vs. 17.9%, p=0.003), previous abdominal surgery (18.6 vs. 7.7%, p=0.014), and postoperative ileus (58.1 vs. 16.9%, p=0.006). In the multivariable regression model, diabetes mellitus (odds ratio [OR] 4.9, 95%CI 2.3-10.1; p<0.001), postoperative ileus (OR 8.1, 95%CI 4.1-16.5; p<0.001), and chronic obstructive pulmonary disease (OR 2.6, 95%CI 1.2-5.7; p=0.013) were independent predictors of abdominal wound dehiscence following radical cystectomy., Conclusion: Diabetes mellitus, chronic obstructive pulmonary disease, and postoperative ileus were strongly associated with abdominal wound dehiscence following radical cystectomy. Both potential preventive and therapeutic interventions may decrease the risk of wound dehiscence.

Objective: Postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) plays an important role in the management of advanced germ cell testicular tumors. Bilateral template lymph node dissection is considered a standard treatment in postchemotherapy residual masses; however, modified unilateral templates have gained acceptance in patients with unilateral residual disease. In this study, we aimed to demonstrate the perioperative and oncological outcomes of the patients with advanced testicular cancer who underwent unilateral modified template PC-RPLND in our center., Methods: This is a retrospective study in which patients who underwent PC-RPLND in a referred center between 2004 and 2021 were investigated. All patients had three or four cycles of chemotherapy and retroperitoneal residual masses. Data were retrospectively collected from medical, operative, radiology, and pathology records and analyzed., Results: A total of 57 patients underwent PC-RPLND. The mean age was 32.7±8.1 years (19-50). According to the disease stage at presentation, there were 39 patients with stage 2 and 18 patients with stage 3. The average tumor size after chemotherapy was 57.6±2.7 mm (25-117). The overall complication rate was 35% (20/57 patients). No grade 4 and 5 complications were observed. Pathologic review demonstrated the presence of teratoma in 28 (49.1%) patients, fibrosis and/or necrosis in 15 (26.3%) patients, and viable germ cell tumor in 14 (24.5%) patients. The mean follow-up was 69.4 months (8-201). During follow-up after surgery, 14 (24.5%) deaths occurred due to advanced disease., Conclusion: PC-RPLND is a major component of the management of advanced testicular germ cell cancer. Our study demonstrated that modified unilateral template is an effective and safe procedure in the postchemotherapy setting for selected patients.

Purpose: We aimed to investigate the histopathological correlation of the suspected prostate malignancy detected in multiparametric prostate magnetic resonance imaging (mpMRI)., Materials and Methods: The data of 93 patients underwent radical prostatectomy and had preoperative mpMRI were examined. Age and pre-operative Prostate-Specific Antigen value were retrospectively collected from patient files. The pathology specimens were examined again and post-operative ISUP grade group, other pathological findings (seminal vesicle invasion, lymph node involvement and extraprostatic extension), pre-operative mpMRI were re-examined and PIRADS score, extracapsular extension, seminal vesicle invasion, neurovascular bundle invasion, lymph node involvement and ADC values were recorded., Results: 151 (92,07%) of 164 lesions detected in mpMRI were histopathologically correlated. 80% of patients with seminal vesicle invasion (P < 0.001), 28.8% of patients with extracapsular extension (P < 0.052) and 42.9% of patients with lymph node involvement (P = .001) in mpMRI were histopathologically correlated. A significant relationship was found between PIRADS scores and ISUP grade groups (P < 0.001). There was a negative correlation between ADC values and ISUP grade groups (P < 0.001)., Conclusion: Our study showed that the lesions detected by mpMRI showed a high histopathological correlation.

Purpose: We aimed to investigate the effect of percutaneous nephrostomy (PCN) implementation on the second ureteroscopy (URS) outcomes after a failed URS., Materials and Methods: The data of four hundred forty-eight patients with an unsuccessful URS history were evaluated. Patients were divided into two groups; patients who underwent PCN before second URS (Group A) and patients who did not (Group B). We compared the stone access rate in the second URS between the two groups according to patient and stone characteristics and operative data. Then, group A was subdivided into two groups according to stone access as; access succeeded (Group A1) and access failed (Group A2). We also compared stone access rates between these two groups in terms of gender, age, body mass index, stone size, side, location, grade of hydronephrosis and PCN duration.  All data were available immediately after surgery and obtained from patient files and the outcome assessment was performed during the study period., Results: Stone access rate was higher in group A than group B (143/196 vs 41/252, P = .0018). Mean nephrostomy duration and mean hydronephrosis grade were significantly higher and mean stone size was significantly lower in group A1 than group A2 (18.74 vs 9.62 days, P < .001; grade 3.25 vs 1.21, P = .038; and 7.286 vs 12.631 mm P < .001, respectively)., Conclusion: PCN is a favourable intervention after a failed URS and increases the success rate of the second operation with ease of implementation and minimal morbidity.

Prostate cancer is one of the most common cancers in men, with a high incidence rates in Turkey. However, the early detection and diagnosis rates are considerably lower among Turkish men as compared with their counterparts in Western countries. This fact reflects a lack of awareness and fear of prostate cancer as well as low prevention activities. To reduce the disparities in prostate cancer survival, there is a great need to increase men's participation in screening programs. The present study was performed to assess why men do not seek screening or participate in screening programs, focusing on the demographics of men refusing a free screening program for prostate cancer.