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Introduction: Herein, we analyzed the histopathological, oncological and functional outcomes of testis-sparing surgery (TSS) in patients with distinct risk for testicular cancer. Methods: This is a multicenter retrospective study on consecutive patients who underwent TSS. Patients were categorized in high- or low-risk testicular germ cell tumor (TGCT) according to the presence/absence of features compatible with testicular dysgenesis syndrome. Histology was categorized per size and risk groups. Results: TSS was performed in 83 patients (86 tumors) of them, 27 in the high-risk group. Fifty-nine patients had a non-tumoral contralateral testis present. Sixty masses and 26 masses were benign and TGCTs, respectively. No statistical differences were observed in mean age (30.9 ± 10.32 years), pathological tumor size (14.67 ± 6.7 mm) between risk groups or between benign and malignant tumors (p = 0.608). When categorized per risk groups, 22 (73.3%) and 4 (7.1%) of the TSS specimens were malignant in the high- and low-risk patient groups, respectively. Univariate analysis showed that the only independent variable significantly related to malignant outcome was previous history of TGCT. During a mean follow-up of 25.5 ± 22.7 months, no patient developed systemic disease. Local recurrence was detected in 5 patients and received radical orchiectomy. Postoperative testosterone levels remained normal in 88% of those patients with normal preoperative level. No erectile dysfunction was reported in patients with benign lesions. Conclusion: TSS is a safe and feasible approach with adequate cancer control, and preservation of sexual function is possible in 2/3 of patients harboring malignancy. Incidence of TGCT varies extremely between patients at high and low risk for TGCT requiring a careful consideration and counseling. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the potential significance of the second transurethral resection of a bladder tumor (TURBT) in a population of patients whose primary pathology was high-grade pTa (Ta/HG) and who had received Bacillus Calmette-Guérin (BCG) treatment for at least 12 on oncological outcomes, based on the presence or absence of detrusor muscle. Materials and Methods: Patients with primary Ta/HG tumors (n=207) that met the inclusion criteria were grouped based on the presence of muscle tissue in the first TURBT and whether the secondary TURBT was performed. Progression, recurrence, and disease-free survival rates were compared between the groups. Results: Median follow-up period was 24 (12-205) months. In cases with muscle in the first TURBT, a second TURBT significantly increased the median disease-free survival time compared with those that did not undergo the second TURBT [32 months (12-83) vs 12 months (6-67); p<0.005]. In cases without muscle in the first TURBT, the second TURBT significantly reduced the rate of progression (p<0.05). Regression analysis showed that tumor size >3 cm [95% confidence interval (CI)=1.09-2.96, hazard ratio (HR)=1.79, p=0.021], presence of muscle tissue (95% CI=0.35-0.92, HR=0.57, p=0.022), and multiple tumor (95% CI=1.06-2.90, HR=1.75, p=0.028) were independent factors affecting disease relapse in primary Ta/HG tumor. Conclusions: In patients with primary Ta/HG tumors, if there was no muscle in the first TURBT, a second TURBT should be performed to achieve lower progression rates. If there is muscle in the first TURBT, the second TURBT will only increase the median disease-free survival time. [ABSTRACT FROM AUTHOR]

Objective: Coronavirus disease-2019 (COVID-19) pandemic changed various priorities in health area. Many elective surgeries for renal cell cancers (RCC) have been postponed. We examined the influence of the COVID-19 pandemic on the surgical treatment of RCC in Turkey. Materials and Methods: Surgically treated 457 patients for kidney tumor, from March 1, 2019 to February 28, 2021 in 9 centers in Turkey were analyzed retrospectively. Results: The number of surgical treatments for RCC during the COVID-19 pandemic has decreased significantly, in contrast to the same period before COVID-19. Admission symptoms were similar in these two periods (p=0.32). However, although not statistically significant, the rate of admission to hospital due to hematuria was higher during the pandemic period compared to the prepandemic period (14.4% vs 9.8%, respectively). The two study periods differed significantly in terms of the rate of metastatic RCC detected in preoperative imaging (13.1% vs 6.1%, during COVID-19 and pre-COVID-19, respectively) (p=0.01). Moreover, the study periods differed significantly in terms of time between imaging and operation [35 (2-240) vs 30 (1-210) days, during COVID-19 and pre-COVID-19, respectively] (p=0.01). However, these two periods were similar in terms of tumor size, type of surgery, and pathological stage (p≤0.05). Although the pathological stages were similar among the groups, nephrectomies due to the metastatic disease were significantly higher in the pandemic period (p=0.01). Conclusion: The number of RCC-related surgeries were significantly decreased during the pandemic period. However, the rate of surgery for metastatic disease has significantly increased. [ABSTRACT FROM AUTHOR]