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Both transperineal and transrectal ultrasound (TRUS)-guided systematic biopsy are accepted methods to diagnose prostate cancer (PCa). However, systematic sampling misses up to 47% of tumors 0.5 mL or larger and under-represents the tumor grade in 38% of cases [1,2]. These shortcomings result in underestimated risk and repeat prostate biopsies.

The aim of this study was to evaluate consistency between clinical lymph node positivity and pathological lymph node positivity in patients undergoing open radical cystectomy and pelvic lymph node dissection due to bladder cancer.A total of 135 patients who had open radical cystectomy, extended lymph node dissection, and clear preoperative contrast-enhanced abdominopelvic computed tomography (CT) or magnetic resonance imaging (MRI) images were included in the study. Positive clinical lymph nodes and positive pathological lymph nodeswere recorded. The largest positive clinical and pathological lymph nodeswere recorded. In terms of clinical lymph node involvement, compatibility between radiological findings and pathological results was evaluated.In the CT group, the sensitivity was 25.81%, specificity was 95.45%, positive predictive value (PPV) was 66.67%, negative predictive value (NPV) was 78.50%, and accuracy was 77.31%. In the MRI group, the sensitivity was 50.00%, specificity was 100%, PPV was 100%, NPV was 76.92%, and accuracy was 81.25%. For consistency between pathological lymph nodes and clinical lymph nodes according to the imaging type, there was no statistically significant difference in the sensitivity, specificity, NPV, and accuracy rates between the imaging techniques (Positive lymph nodes play a critical role in the prognosis of patients with bladder cancer and the sensitivity of contrast-enhanced abdominopelvic CT and MRI used routinely in clinical practice is low in lymph node detection. MRI seems more reliable than CT in lymph node detection.

To evaluate the ability of thiol-disulphide homeostasis to predict renal injury in ureteral obstruction by matching renal scintigraphy and pathological findings in an experimental rat model. 24 rats were randomized and divided into 3 groups as sham, partial and complete. Blood samples for biochemical evaluations and dimercaptosuccinic acid (DMSA) renal scintigraphy were performed at the beginning and on the 7th day postoperatively. Only a midline abdominal incision was done in sham group. Left ureter of partial group was dissected and gently buried into the psoas muscle. In complete group, left ureter was dissected and ligated. Statistically significant association was found between left kidney function loss percentage, native thiol, total thiol and creatinine alterations and pathological EGTI (Endothelial, Glomerular, Tubular, Interstitial) scores (r = − 0.867, r = − 0.815, r = 0.745, r = − 0.911; p = 0.000). Statistically significant difference was detected between groups in terms of postoperative native thiol and total thiol values (p = 0.000, p = 0.001). There was also a significant difference in preoperative and postoperative comparisons of these parameters in partial and complete obstruction groups (p = 0.012, p = 0.018). There was a significant difference in terms of postoperative disulphide/native thiol and native thiol/total thiol ratios in complete obstruction group compared to other groups (p1 = 0.011, p2 = 0.040; p1 = 0.015, p2 = 0.028). Association with scintigraphic and pathological results empowers the value of this parameter. Disulphide/native thiol and native thiol/total thiol ratios indicate complete obstruction. These findings may shed light to more comprehensive studies.

SUMMARY INTRODUCTION Due to spongiofibrosis and inflammatory processes underlying the pathogenesis of urethral stricture, it is possible that the neutrophil-lymphocyte ratio (NLR) may give essential information about the course of the disease and recurrence possibilities. Our study aims to evaluate the correlation between NLR and recurrence rates. METHODS A total of 512 patients who underwent direct visual internal urethrotomy (DVIU) due to urethral stricture in our clinic between February 2010 and January 2018 were evaluated retrospectively. RESULTS The median follow up for non-recurrent and recurrent groups after DVIU was 30 and 36 months, respectively. During the follow-up, 280 (54.7%) of the patients had recurrences, and 232 (45,3%) had no recurrences. The mean time for recurrence after DVIU was 6,5±1,4 months, with a range of 1-36 months. The mean NLR in the non-recurrence group was 2,02±0,87, with a median of 1.9, and 3,66±2,30, with a median of 3 in the recurrence group. A highly significant statistical difference was observed between two groups in terms of neutrophil count and NLR (p: 0.000 – both). The area under curve value for NLR was 0.767, with a standard error of 0.021 (95% CI 0.727-0.808). The cut-off value of NLR was determined as 2.25, with a 70% sensitivity and 67,7% specificity. CONCLUSION By using NLR, the inflammatory features of the urethral tissue can be predicted, and possible recurrences after surgery can be estimated. Consequently, open urethroplasty techniques can be used in cases with a significant NLR value instead of the recurrent endoscopic procedure. RESUMO INTRODUÇÃO Devido à espongiofibrose e processos inflamatórios subjacentes à patogênese da estenose uretral, pode-se pensar que a relação de linfócitos neutrofílicos (NLR) pode fornecer informações essenciais sobre o curso da doença e as possibilidades de recorrência. O objetivo do nosso estudo é avaliar a correlação entre NLR e taxas de recorrência. MÉTODOS Quinhentos e doze pacientes submetidos à uretrotomia interna visual direta (DVIU) devido à estenose uretral em nossa clínica entre as datas de fevereiro de 2010 e janeiro de 2018 foram avaliados retrospectivamente. RESULTADOS A mediana de acompanhamento para os grupos não recorrentes e recorrentes após a DVIU foi de 30 e 36 meses, respectivamente. Durante o seguimento, 280 (54,7%) dos pacientes tiveram recidivas e 232 (45,3%) não tiveram recidivas. O tempo médio de recorrência após a DVIU foi de 6,5±1,4 mês, com variação de 1-36 meses. A média da RNL no grupo sem recorrência foi de 2,02±0,87 com mediana de 1,9 e 3,66±2,30 com mediana de 3 no grupo com recidiva. Uma diferença estatística altamente significativa foi observada entre dois grupos em termos de contagem de neutrófilos e NLR (p: 0,000 - ambos). A área sob o valor da curva para NLR foi de 0,767 com um erro padrão de 0,021 (IC 95% 0,727-0,808). Valor de corte de NLR determinado como 2,25 com uma sensibilidade de 70%, especificidade de 67,7%. CONCLUSÃO Ao utilizar a RNL, as características inflamatórias do tecido uretral podem ser previstas e possíveis recidivas após a cirurgia podem ser estimadas. Dessa forma, técnicas de uretroplastia aberta podem ser usadas em casos com valor significativo de NLR em vez de procedimento endoscópico recorrente.

The freehand (FH) technique of transperineal prostate biopsy using commercialized needle access systems facilitates a reduction in anesthesia requirements from general to local or local/sedation. We sought to compare the efficacy and complication rates of the FH method with those of the standard grid-based (GB) method.The GB method was performed from 2014 to 2018, and the updated FH technique was performed from 2018 to 2020, yielding comparative cohorts of 174 and 304, respectively.The FH and GB techniques demonstrated equivalent yields of ≥Gleason grade group (GGG)-2 prostate cancer (PCa). The FH group had a significantly higher mean number of cores with ≥GGG-2 PCa involvement (p=0.011) but a significantly lower mean number of biopsy samples (p0.01). The urinary retention rate of the GB group (10%) was significantly higher than that of the FH group (1%; p0.01). The rates of ≥GGG-2 PCa involvement in the anterior (GB, 31%) and anteromedial (FH, 22%) sectors were higher than those in other sectors (range, 0%-9%). For multiparametric magnetic resonance imaging, the rate of ≥GGG-2 PCa detection in the anteromedial prostate (23%) was nearly half that in other locations (range, 38%-55%).Compared with GB transperineal biopsy, FH transperineal biopsy demonstrates an equivalent cancer yield with no risk of sepsis, a significantly reduced risk of urinary retention, and reduced anesthesia needs. The higher number of cores with ≥GGG-2 PCa involvement in the FH group suggests that FH transperineal biopsy can sample the prostate better than GB-transperineal biopsy can.

Amaç: Bu çalışmada, prostat kanseri tanısında thiol/disülfid dengesinin prostat spesifik antijene (PSA) ek bir serum markırı olarak değerlendirmeyi amaçladık. Hastalar ve Yöntemler: Prospektif çalışmamız PSA düzeyi 2.5-20 ng / mL olan, rektal muayenede malignite şüphesi olmayan ve prostat iğnesi biyopsisi yapılan toplam 174 hasta üzerinde yapıldı. Dışlama kriterleri sonrası çalışmamıza toplam 75 hasta dahil edildi. Biyopsi öncesi hastaların serum PSA, thiol ve disülfid düzeyleri kaydedildi. Çalışmamıza patoloji sonucu prostat kanseri olan 25 hasta, patoloji sonucu kronik prostatit olan 25 hasta ve patoloji sonucu benign prostat hiperplazisi (BPH) olan 25 hasta dahil edildi. Bulgular: Prostat kanseri grubunda total ve native thiol seviyeleri BPH ve kronik prostatit gruplarından daha yüksekti; ancak, istatistiksel anlamlı bir farklılık gözlenmedi (p> 0.05). Prostat kanseri alt grupları incelendiğinde, total ve native thiol seviyelerinin Gleason skoru 7, 8 ve 9 olan hastalarda, Gleason skoru 6 olanlara göre daha yüksek olduğu saptandı; ancak, istatistiksel anlamlı bir fark gözlenmedi (p> 0.05). Sonuç: Thiol seviyeleri prostat kanseri grubunda, benign hastalık (BPH ve kronik prostatit) gruplarından daha yüksekti; bu seviyeler aynı zamanda Gleason skoru yüksek olan grupta (Gleason 7, 8 veya 9), Gleason skoru düşük olan (Gleason 6) gruba göre daha yüksekti; ancak, bu farklılıklar istatistiksel olarak anlamlı değildi., Aim: We aimed to investigate thiol/disulphide homeostasis as an additional serum marker to prostate specific antigen (PSA) in the diagnosis of prostate cancer. Patients and Methods: Prospective study was conducted among 174 patients with PSA levels of 2.5–20 ng/mL without suspicion of malignancy in rectal examination and who underwent prostate needle biopsy. A total of 75 patients were included in our study after exclusion criteria. Serum PSA, thiol, and disulphide levels of the patients were recorded prior to biopsy. In this study, 25 patients with pathology results indicating prostate cancer, 25 randomly selected patients with pathology results indicating chronic prostatitis, and 25 randomly selected patients with pathology results indicating benign prostate hyperplasia (BPH) were included. Results: Total and native thiol levels were higher in prostate cancer group than in BPH and chronic prostatitis groups; however, no statistically significant difference was observed (p> 0.05). When prostate cancer sub-groups were investigated, total and native thiol levels were noted to be higher in patients with a Gleason score of 7, 8, and 9 than in those with a Gleason score of 6; however, no statistically significant difference was observed (p> 0.05). Conclusions: Thiol levels were higher in prostate cancer group than in benign disease (BPH and chronic prostatitis) groups; these levels were also higher in group with high Gleason scores (Gleason 7, 8, or 9) than in group with a low Gleason score (Gleason 6); however, these differences were not statistically significant.

Objective: Prostate cancer (PC) is the most common malignancy among men worldwide. There are several epidemiological studies linking the risk and outcome of vitamin D with PC. In this study, we aimed to compare vitamin D levels in patients with PC and benign prostatic hyperplasia (BPH). Materials and Methods: Patients with PC and BPH admitted to our urology outpatient clinic between 2017 and 2019 were included in this case-control study. Serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels were measured to assess vitamin D status. Results: The study was conducted with a total of 256 patients aged between 47 and 86 years between 2018-2019. The mean age of 128 patients with PC was 67.70±7.74 years, and the mean age of 128 patients with BPH was 67.03±7.89 years. There was a statistically significant difference between patients with PC and BPH in terms of 25-hydroxyvitamin D levels. When the patients diagnosed with PC were examined according to their subgroups, the mean 25-hydroxyvitamin D levels of 64 patients with ISUP Grade I tumors were significantly higher than the remaining 64 patients with ISUP Grade II, III and IV tumors. Conclusion: According to our results, vitamin D levels were found to be significantly lower in patients with PC than in patients with BPH, and a significant decrease was found in vitamin D levels as the Gleason score increased. Since PC has a high prevalence and heterogeneous geographical distribution, randomized controlled trials are needed in order to demonstrate the relationship between vitamin D and cancer.

We aimed to evaluate plasma thiol and disulphide levels as an additional marker to prostate specific antigen (PSA) in the diagnosis of prostate cancer (PCa).Between March 2017 and January 2018 prospective study was conducted among patients with PSA levels of 2.5-20 ng/mL without suspicion of malignancy in rectal examination and who underwent prostate needle biopsy. Patients were divided into two groups according to PSA level as 2.5-10 ng/mL (Group 1) and 10.01-20 ng/mL (Group 2). Diagnostic efficacy of thiol, disulphide and PSA levels were measured by ROC analysis.A total of 76 patients were included in the study. There were 49 patients in group 1 and 27 patients in group 2. There was no significant difference between two groups in terms of PSA density and prostate size. In Group 1, area under curve (AUC) was higher in PSA than other parameters with statistically significant difference (We think that plasma thiol test may be used in diagnosis of prostate cancer while PSA levels between 10 to 20 ng/mL. However, further studies are required.

To investigate the accuracy of Briganti nomogram in patients who underwent Pelvic lymph node dissection (PLND).Hundred and sixty-five patients who underwent radical prostatectomy and PLND between 2012 and 2018 in our clinics were included, and their data were retrospectively screened.The mean age of patients was 63.6 ± 5.8 (range: 49-76) years. Hundred and thirty-five (81.8%) patients had a Briganti score of5, whereas 30 (18.2%) had a Briganti score of ≥5. The preoperative T-PSA levels, biopsy grades and the incidence of T2b and T2c stages in patients with a Briganti score of ≥5 was significantly higher than that in patients with a Briganti score of5 (Nomograms provide useful information regarding prostate cancer. Risk estimates should be carefully considered, and treatment decisions should be given with a patient-specific approach.

After radical prostatectomy (RP) or radiotherapy (RT) for prostate cancer, erectile dysfunction (ED) is the main complication next to urinary incontinence, affecting quality of life. The pathophysiology of ED after these treatments is believed to include neuropraxia causing reduced oxygenation and structural changes of the tissue in the corpora cavernosa. Next to the option of sparing the nerves during RP, research has been focusing on methods for penile rehabilitation after RP and RT, since it occurs often, even after nerve-sparing techniques were used. In animal studies, the use of phosphodiesterase type 5 inhibitors (PDE5i) after cavernous nerve damage is supported, but results in human studies are contradictory. Non-medical treatment options such as vacuum device therapy, hyperbaric oxygen therapy, yoga, aerobic, or pelvic floor training may be helpful, but evidence is scarce. Clear guidelines for penile rehabilitation are not yet available. However, care and support for ED after RP and RT is highly demanded by a large group of patients, so measures have to be taken even though the evidence is not strong yet. In this systematic review, an overview of the literature for penile rehabilitation and treatment options for ED after RP and RT is provided, using only randomized controlled trials (RCT). ispartof: FRONTIERS IN SURGERY vol:8 ispartof: location:Switzerland status: published

To investigate the effect of platelet-rich plasma (PRP) in reducing renal injury in ureteral obstruction. Twenty-four Wistar Albino rats were randomized and divided into four groups as the donor (n = 6), sham (n = 6), saline (n = 6), and PRP (n = 6). Blood was obtained from the donor group by cardiac puncture and PRP was prepared. 2 cc blood was sampled from other groups to measure blood-urea nitrogen and creatinine levels. Baseline renal scintigraphy was performed. An abdominal midline incision was made and the left ureter was exposed in the sham group. Saline infusion was given to the kidneys of the saline group after left ureteral obstruction, while PRP was given to the PRP group. On postoperative Day 7, control biochemical and scintigraphic evaluations were performed and left nephrectomies were done. Left kidneys were evaluated histopathologically. DMSA measurements in the sham group were found to be significantly higher than the saline and PRP groups (p = 0.001 and p = 0.024, respectively). There were no significant differences between the saline and PRP groups (p = 0.525 and p > 0.05, respectively). Histopathologically, no significant difference was observed between the saline and PRP groups (p = 0.320), while the scores of the sham group were significantly higher than the saline and PRP groups (p = 0.02 and p = 0.001, respectively). Our study results suggest that PRP may be effective in preventing ureteral obstruction-induced renal injury.

Aim We aimed to investigate the predictor role of the systemic immune-inflammation index (SII) on Bacille Calmette-Guerin (BCG) response in patients with high-risk non-muscle invasive bladder cancer (NMIBC). Methods A total of 96 patients with high-risk NMIBC, who received intravesical BCG, were enrolled in the study. BCG responsive group (group 1) and BCG failure group (group 2) were compared in terms of demographic and pathological data, peripheral lymphocyte, neutrophil and platelet counts, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), SII, recurrence-free survival (RFS) and progression-free survival (PFS). The SII was calculated as in the formula: SII = neutrophil × platelet/lymphocyte. The prognostic ability of the SII for progression was analysed with multivariate backward stepwise regression models. Results The mean follow-up time 34.635 ± 14.7 months. Group 2 had significantly higher SII, peripheral lymphocyte, neutrophil and platelet counts than group 1. An ROC curve was plotted for the SII to predict the BCG failure and the cut-off point was calculated as 672.75. Effect of the SII to the model was statistically significant (P = .003) and a higher SII increased the progression onefold. A tumour greater than 30 mm in size and a high SII together increased the progression 3.6 folds. Conclusions The SII might be a successful, non-invasive and low-cost parameter for prediction of BCG failure in patients with high-risk NMIBC. The cut-off value for SII is 672.75 and above this level BCG failure and progression to MIBC might be anticipated. However, these results should be validated in prospective randomised controlled studies with large patient groups.

Objective: To demonstrate two distinct methods for adopting the single-port (SP) robotic surgery system for robotic-assisted laparoscopic prostatectomy (RALP) by two experienced robotic surgeons (J...

Background Platelet-rich plasma is a biological instrument rich in growth factors and cytokines. Objectives The aim of this study was to investigate the effect of platelet-rich plasma on spermatogenesis and hormone production in an experimental testicular torsion model. Materials and methods The rats were randomly divided into three groups, including six rats in each group as follows: the first group as the sham group; the second group as the ischemia/reperfusion + Saline group and the third group as the ischemia/reperfusion + platelet-rich plasma group. The left testicles of the ischemia/reperfusion + Saline and ischemia/reperfusion + platelet-rich plasma group were kept in four-hour torsion. Then, the left testicles of ischemia/reperfusion + Saline and ischemia/reperfusion + platelet-rich plasma groups were detorsioned, and intra-testicular 1 cc saline (ischemia/reperfusion + Saline) and 1 cc platelet-rich plasma (ischemia/reperfusion + platelet-rich plasma) were injected. At one month, blood samples were taken from all groups for hormonal evaluation and left orchiectomy was performed. Results The mean follicle-stimulating hormone level of ischemia/reperfusion + Saline group was significantly higher than ischemia/reperfusion + platelet-rich plasma group (7.78 ± 0.23 vs 6.18 ± 0.28 nmol/l, respectively, P = .004). The mean LH level of ischemia/reperfusion + platelet-rich plasma group was significantly lower than ischemia/reperfusion + Saline group (3.63 ± 0.28 vs 5.68 ± 0.21 nmol/l, respectively, P = .004). The mean total testosterone level of ischemia/reperfusion + platelet-rich plasma group was significantly higher than ischemia/reperfusion + Saline group (8.05 ± 0.24 vs 5.78 ± 0.23 nmol/l, respectively, P = .004). The mean Johnsen scores of ischemia/reperfusion + platelet-rich plasma group were significantly higher than ischemia/reperfusion + Saline group (5.85 ± 0.58 vs 3.93 ± 0.65, respectively, P = .004). The mean Johnsen score of the sham group was significantly higher than ischemia/reperfusion + platelet-rich plasma and ischemia/reperfusion + Saline groups (P = .003 and P = .003, respectively). Discussion and conclusion The platelet-rich plasma has beneficial effects on spermatogenesis and reproductive hormone production in testicular torsion. It is easily accessible and applicable. In the future, intra-testicular platelet-rich plasma injection may be used in testicular torsion after detorsion. However, further experimental and large-scale prospective clinical studies are needed to establish a definitive conclusion on this topic.

INTRODUCTION AND OBJECTIVE:Transperineal (TP) prostate biopsy has traditionally been described using a brachytherapy style grid and often using general anesthesia due to the large number of transcu...

INTRODUCTION AND OBJECTIVE:Obstructive uropathies can lead to progressive nephron loss at all ages. Renin-angiotensin system and other pathways induced by the increase of intraglomerular pressure d...

SUMMARY OBJECTIVE We aimed to determine whether atherogenic dyslipidemia is associated with the disease and morbidity in our patients treated for Fournier’s gangrene (FG). METHODS Sixty-two patients who were treated with the diagnosis of FG at our center between 2012 and 2017 were retrospectively screened. RESULTS The triglyceride values of the patients who required reconstructive surgery were statistically significantly higher than those of the patients for whom wound debridement and primary suturing was sufficient (p:0.001). A total of 65.7% of the patients had normal triglyceride values in the group in which wound debridement and primary suturing was sufficient, while this rate was 22.2% in the group of patients who needed reconstructive surgery; the difference was statistically significant (p: 0.002). The UFGSI score of those with triglyceride values higher than the normal range was statistically significantly higher (p:0.006). The cut-off point for the triglyceride value for which Fournier’s gangrene was more morbid and the probability of reconstructive surgery need was significantly higher, i.e., >233mg. CONCLUSION Our study has demonstrated that atherogenic dyslipidemia, especially hypertriglyceridemia, is an important factor affecting morbidity and associated with high patient care costs after hospitalization and discharge in FG.

BACKGROUND The most common extra pulmonary organ dysfunction in acute respiratory distress syndrome is acute kidney injury. Current data so far indicate low incidence of AKI in Covid-19 disease. OBJECTIVE In this retrospective study, we analysed the clinical features of patients diagnosed with Covid-19 and investigated the effect of Covid-19 on kidney function. METHODS Ninety-six patients diagnosed with Covid-19 were included in our study. Demographic features (Age, gender, co-morbidities), symptoms, thorax CT findings, Covid-19 PCR results and laboratory findings were recorded. The clinical features of the patients were analysed and kidney function values before Covid-19 diagnosis were compared with kidney function values after Covid-19 diagnosis. RESULTS Most presenting symptom was fever (51%). Most accompanying co-morbidity was hypertension (56%). According to laboratory findings; ferritin, D-dimer and C-reactive protein levels were statistically significantly higher in ARDS group than severe pneumonia and pneumonia group (P = .002, P = .001 and P

Asexuality is commonly regarded as lack of sexual attraction. Research in asexuality grew progressively in the past two decades. However, asexuals’ patterns of sexual behavior and psychological processes were not yet systematized. This review searched for articles that could potentially help establishing these patterns. Articles published in English until December 31st 2019 were retrieved from Medline, Embase, Cochrane, EBSCO, PubMed, Scopus, and PsycARTICLES. A systematic search was conducted using an exhaustive list of key terms regarding asexuality and sexual behavior following PRISMA guidelines. Of the 195 initially retrieved, only 23 were considered for this review. Of the 23 articles, 16 were quantitative studies, 5 were qualitative studies, and 2 comprised quantitative and qualitative studies. Overall, current findings suggest that asexuals present great heterogeneity of sexual behaviors and psychological processes regarding sexuality, including different aspects and types of interpersonal and romantic relationships, sexual attitudes or fantasies. Conversely, data did not find support for the claim that asexuals present impaired sexual functioning. The little geographic and cultural diversity of thesamples is a major limitation in thesestudies, preventing the properly representation of asexuals. Furthermore, asexuals may benefit from evidence on the biopsychosocial factors shaping sexual, emotional, and relationship well-being, as far as such evidence is built upon asexuals’ lenses, rather than on heteronormativity criteria.

Topaktas, Ramazan/0000-0003-3729-3284 WOS: 000577891700014 PubMed: 33133662 Introduction We investigated the clinical, operational, and pain parameters of patients who underwent semirigid ureterorenoscopy (sURS) under spinal anesthesia (SA) and general anesthesia (GA) for proximal ureter stones. Material and methods Patients treated with sURS after diagnosis of proximal ureter stones between January 2014 and May 2017 were reviewed retrospectively. The patients were divided into two groups (the SA group and the GA group) based on the type of anesthesia used. Perioperative variables and operation results were evaluated and compared. Success was defined as the patient being stone-free as observed on low-dose non-contrast computed tomography performed in the first month postoperatively. Results The SA and GA groups had 40 and 32 patients, respectively. There were no statistically significant differences between the groups in terms of age (p = 0.593), gender (p = 0.910), average stone size (p = 0.056), side (p = 0.958), or density (p = 0.337). Based on the Clavien classification system, complication rates between the two groups were similar. The postoperative visual pain scale in the SA group was statistically significantly lower (p

Anogenital distance (AGD) is the length between the genitals and anus which shows an androgenic activity in the evolution of the reproductive system in the uterine life. For prostatic evolution and development during the embryological stage, androgen exposure is required. In this study, we aimed to investigate the relationship between AGD and benign prostate hyperplasia (BPH)-related lower urinary tract symptoms (LUTS). A total of 70 patients who were admitted to our urology clinics with LUTS due to BPH (LUTS group) and 70 patients without LUTS (control group) were included. All patients were administered an International Prostate Symptom Score form. Data including height, weight, body mass index, total prostate-specific antigen, prostate volume and uroflowmetry Qmax values of all patients were evaluated. The AGD of the LUTS and control groups was measured. The mean AGDAS values of the LUTS group were significantly lower than the control group (p = .013). There was no statistically significant difference between the two groups in terms of the mean adjusted AGDAP values (p = .241). However, the mean adjusted AGDAS values were significantly lower in the LUTS group than the control group (p = .002). Our study results suggest that AGD may be a useful marker in BPH-related LUTS.

Our aim was to measure the ability of ischaemia-modified albumin (IMA) to predict testicular histopathological damage in the testes of rats with short- and long-term ischaemia using experimental testicular torsion and subsequent reperfusion via detorsion.21 Wistar Albino rats were randomized into three groups. The sham group was subjected to a mid-scrotal incision only. The 4- and 8-hr T/D (Torsion/Detorsion) groups were subjected to left testicular torsion by twisting the testes by 720 degrees counterclockwise. 2 cc venous blood samples were taken from the sham group after the mid-scrotal incision, and from the 4- and 8-hr T/D groups after 4 and 8 hr respectively. After that, the 4- and 8-hr T/D groups were subjected to detorsion. Two days later, orchiectomy was performed. Ischaemia-modified albumin levels were significantly different among the groups at 48 hr prior to orchiectomy (reperfusion; p = .003). Based on the results of the paired comparisons, it was found that IMA levels of the sham group were significantly higher than those of the 4- and 8-hr T/D groups (p = .002 and .009 respectively). Our study has showed that IMA may be used to predict ischaemia/reperfusion injury, which is another complication that may occur following detorsion in testicular torsion.

OBJECTIVE To evaluate the association of obesity with Gleason scores determined in biopsy and radical prostatectomy specimens. STUDY DESIGN Cohort study. PLACE AND DURATION OF STUDY Urology Department, Fatih Sultan Mehmet Research Hospital, Istanbul, Turkey from 2007 to 2015. METHODOLOGY A total of 111 patients, younger than 65 years who underwent radical prostatectomy (RP) with the diagnosis of prostate cancer, were included in the study. Histopathology reports of the surgical, and TRUS-guided prostate biopsy specimens were analysed. Body mass index (BMI) and prostate specific antigen (PSA) levels were also evaluated. RESULTS Mean age of the patients was 59.06 ±4.10 (range = 47-64 years) years. Mean BMI of the patients was 25.59 ±3.24 kg/m2 (range = 19-35 kg/m2). In patients whose BMI measurements were equal or above 25 kg/m2; a significant difference was found between Gleason scores of the needle biopsy and RP specimens (p=0.001). CONCLUSION BMI and PSA, which are known to be the most important parameters effecting Gleason score, were evaluated in combination. Regarding non-concordance with Gleason scores, it has been observed that as a predisposing factor, obesity can explain these incompatibilities similarly to PSA.

Objective: The aim of this study was to compare depression and sexual dysfunctions observed in primary and secondary infertile patients. Material and method: The study was performed in 39 primary and 31 secondary infertile male patients. Male sexual health was evaluated using the International Index of Erectile Function (IIEF) score and depression with Beck Depression Inventory (BDI). Results: Mean age of the participants and their partners were 31.54 ± 5.37 (range, 24-48 yrs), and 28.16 ± 5.58 (range, 20- 46 yrs) years, respectively. Mean duration of their marriage ranged between 1 and 17 years (mean, 5.06 ± 4.15 yrs). A statistically significant intergroup difference was detected between groups as for BDI scores (p = 0.015; p < 0. 05). BDI scores of the primary group were significantly lower than those of the secondary group. A statistically and extremely significant difference was detected between IIEF scores of the groups (p = 0.006; p < 0.01). IIEF scores of the primary infertile group were higher than those of the secondary group. Conclusion: Our study, frequency of the depression and erectile dysfunction seen in the patients with secondary infertility was seen significantly higher than the patients with primary infertility.

Paratesticular adenomatoid tumor (PAT) is the most common paratesticular tumor. It is still a concern for today's urologists because it cannot be distinguished from malignant testicular tumors by clinical symptoms, routine examination and imaging methods. Because of the predominant benign nature of paratesticular masses, testicular preservative treatments get to the foreground. However, the fact that virtually all of the solid scrotal masses are malignant and are treated with radicel ingainel orchiectomy (RIO) remains a cause of concern. In this study, we discuss the diagnosis and treatment of 12 paratesticular adenomatoid tumors treated between 2012 and 2017 in two centres. We suggest that a frozen section should be done with the help of an experienced pathologist; and a meticulous microscopic evaluation should be the gold standard in case of a benign tumor suspicion.

Objectives: Anogenital distance (AGD), the distance from the sexual organs to the anus, is a sexually dimorphic feature in mammals. In this study, we investigated the relationship between anogenital distance and prostate cancer (PCa). Methods: 52 patients diagnosed with PCa and 60 patients with benign prostate hyperplasia as a control group were included in the study. AGDAP (cephalad insertion of the penis to the center of the anus) and AGDAS (posterior base (first fold) of the scrotum to the center of the anus) measurements of patients were done and noted before biopsy. Results: The mean ages of 52 patients diagnosed with PCa and 60 patients with benign prostatic hyperplasia (BPH) were 67.70 ± 7.74 and 67.03 ± 7.89, respectively. There was no statistically significant difference in terms of age and serum testosterone levels of the patients diagnosed with prostate cancer or BPH (p > 0.05). Mean PSA values of patients diagnosed with prostate cancer wto be statistically higher than patients with BPH (p = 0.000). The mean AGDAP measurements of patients diagnosed with prostate cancer were statistically higher than those diagnosed with BPH (p = 0.000) and there was no significant difference in AGDAS measurements.(p = 0.823; p > 0.05). Conclusions: Androgen exposure is thought to play a role in the development PCa. Also AGD may be an indicator of prenatal androgen activity. In our study, we found a direct correlation between AGDAP and PCa. In order to reach a definitive conclusion, randomized controlled trials with larger sample number are needed.

Aydin, Cemil/0000-0002-7271-5748; Topaktas, Ramazan/0000-0003-3729-3284 WOS: 000484762600001 PubMed: 31667032 Introduction The aim of this study was to present our results regarding the feasibility and possible complications of 4.5 Fr semi-rigid ureterorenoscopy (URS) treatments in pediatric patients. Methods The files and computer records of a total of 33 pediatric patients (20 males and 13 females), who underwent URS procedures for ureteral stones > 5 mm between January 2013 and June 2017, were retrospectively reviewed. A 4.5 Fr semi-rigid ureteroscope (Ultrathin 4.5/6.5 Fr Ureterorenoscope; Richard Wolf GmbH, Knittlingen, Germany) was used for the URS procedures. For the stone-free rate evaluations, abdominopelvic ultrasound or direct radiography scans were performed one week after the surgery, and low-dose non-contrast computed tomography (CT) was performed during the first month. Results The mean age of the patients was 9.8 +/- 2.8 (range 4-16) years old, and the mean ureteral stone size was 8.9 +/- 1.4 (range 6-13) mm. The mean surgical duration was 45 +/- 21.2 (range 30-75) minutes, and the mean hospital stay length was 1.2 (range 1-4) days. Minor complications occurred in five (15.1%) of the patients. The success rates for the first week and first month were 90.9% and 96.9%, respectively. Conclusion The endoscopic management of pediatric ureteral stones using a 4.5 Fr ureteroscope seems to be a safe and feasible treatment option with high success and low complication rates.

Objective: Testicular cancers, which are less common than other cancers, are important in terms of being seen in young people. Physical examination, imaging, laboratory and tumor markers are used for diagnosis. There are some studies of some blood parameters that can be involved in inflammation and tumorogenesis. We retrospectively compared hematological values measured in our patients who were diagnosed with testicular tumor in comparison with patients with similar age group who underwent varicocelectomy repair. Materials and methods: This cross-sectional retrospective study included 120 patients who underwent radical inguinal orchiectomy for testicular tumor between January 2010 and December 2018, and 171 patients who underwent varicocelectomy as a control group. Patients with an active infection and hematological disorders were excluded from the study. We evaulated hematological parameters including neutrophil (NEU), lymphocyte (LYM), platelet (PLT) count, and mean platelet volume. The study was conducted on 291 patients. divided in two groups: tumor (n = 120) and varicocele (n = 171). Results: There was no statistically significant difference between the groups in terms of PLT / lymphocyte ratio and mean platelet volume (MPV) levels (p > 0.05). The neutrophil /lymphocyte ratio (NLR) of the tumor group was significantly higher than the varicocele group (p = 0.001; p < 0.05). There was a statistically significant difference between the tumor stages in terms of PLT / Lymphocyte ratios (p = 0.006; p < 0.05). Conclusions: There was only a statistically significant increase in NLR values in the testicular tumor group compared to the varicocele group. Larger, randomized controlled studies are needed at this field.

Urogenital cancers are frequently encountered in daily practice. Prostate cancer is the second most common type in adult males, and 2-3% of all adult cancers are renal cell carcinoma. Kaposi's sarcoma originates from vascular endothelial cells and is the most common type of sarcoma observed in HIV-positive patients. However, the development of all these types of cancer in a patient without immunodeficiency is very rare. Incidence of urological malignancies increase with aging. In contrast to normal population, patient who have one urological malignancy have increased risk of getting another urological malignancy in a follow-up. So follow-up of this kind of patients is crucial and needs to be done carefully. In this case report, we aimed to discuss a 68-year-old patient who was diagnosed with concurrent prostate and kidney cancer and developed penile Kaposi's sarcoma in follow-up.

To examine the effects of urethroplasty surgery on sexual functions by taking into account age, location of stenosis, length of stenosis and surgical technique parameters.The prospective study was conducted between January 2015 and August 2017 with 60 cases. Patients were categorized according to age groups (19-65 / 65-75 years), surgery technique and stricture localization and length. Before the urethroplasty operation and postoperative 6th month follow-up, the international index of erectile function (IIEF) form (15 questions), was filled, the relevant domains of sexual function; erectile function (Q1,2,3,4,5,15), orgasmic function (Q9,10) and overall satisfaction (Q13,14) were assessed.The mean age of the cases is 54 ± 13. However, preoperative IIEF, sexual satisfaction and orgasmic function averages of patients with a stenosis segment length of 1-3 cm was found to be significantly higher than that of patients with a stenosis segment length of 4-7 cm. Between stenosis segment length groups, there was no statistical difference in terms of preoperative and postoperative sexual functions. And also, there was no statistically significant change in patients' preoperative and postoperative sexual function scores in terms of localization of stricture and surgery techniques. However, there were statistically significant change in the postoperative IIEF and sexual satisfaction averages according to preoperative averages.Our study suggests that urethroplasty surgery itself does not significantly affect erectile function, orgasmic function, and general sexual satisfaction regardless of the type of surgery, localization and length of stenosis. Besides, there was a significant decrease in erectile function in senior adults.

Artificial urinary sphincter (AUS) implantation is the gold standard treatment in total stress urinary incontinence (SIU). Our aim is to evaluate the effect of AUS implantation on erectile function and sexual satisfaction (SS). Fourteen patients aged 58-73 years (mean: 66.92 ± 4.51 years) who underwent AUS implantation by a perineal approach between May 2015 and April 2018 were included in our study. Patients with neurogenic disease or very low or no erectile function and those who underwent non-nerve-sparing radical prostatectomy were excluded. Erectile function and intercourse satisfaction were evaluated pre-operatively and post-operatively at 6-month follow-up using international index of erectile function (IIEF) questionnaires. After AUS implantation; eight patients were totally dry, four achieved social continence (less than one pad/day), and two still had SUI (two or more pads/day). Mean pre- and post-operative IIEF values of the patients were 16.14 ± 3.18 and 17.42 ± 4.43 respectively. Mean pre- and post-operative SS values were 8.57 ± 1.78 and 8.71 ± 2.19 respectively. There was no statistically significant difference between pre- and post-operative IIEF-5 and intercourse satisfaction scores (p > 0.05). Although we did not see a significant effect of AUS implantation in our study, in SIU patients, coital incontinence or unpleasant odour during intercourse can lead to sexual avoidance and reduced SS, and AUS implantation may improve SS.

Objective: The pathophysiology of urethral stricture and its recurrence remains vague and one of the important causes is progressive inflammation. It has been shown in recent years that the neutrophil / lymphocyte ratio is a marker of systemic inflammation and is associated with prognosis in many cardiovascular diseases, malignancies and chronic inflammatory diseases. We assessed simple systemic inflammation markers preoperatively and surgical techniques for urethral stricture recurrence after urethroplasty. Patients and Methods: After exclusion criteria applied, a total of 117 male cases operated with urethroplasty in our clinic between January 2012 and June 2017 were included in the study and analyzed retrospectively. Localization and length of the strictures of the patients, neutrophil counts and percentages, lymphocyte counts and percentages, and neutrophil / lymphocyte ratios in preoperative peripheral blood samples were statistically analyzed. Recurrent stricture during first 12 months follow-up after the surgery has been assessed as recurrence. Results: The mean age of the patients was 54.12 ± 16.35 and the mean urethral stricture length was 3.44 ± 1.83 cm. Recurrence was observed in 30.1% of cases who received buccal graft, 30% in penile skin applied cases and 26.1% of cases treated with end-to-end anastomosis and there was no statistically significant difference between neutrophil, lymphocyte, neutrophil / lymphocyte ratio and average stricture segment length between recurrent and non-recurrent cases (p > 0.005). Conclusions: We consider that neutrophil, lymphocyte counts and their ratio prior to urethroplasty and the technique performed are not parameters that can be used to predict stricture recurrence. Prospective and randomized new trials with larger patient populations are needed to make more accurate judgments about the role of these inflammatory parameters.

Objective Renal cell carcinoma (RCC) is a tumor that has a tendency of vascular invasion by extending to the inferior vena cava (IVC) after the renal vein. The total resection of the renal tumor and tumor thrombus is considered the optimal treatment. In our study, we aimed to present the results related to 34 consecutive cases of RCC with tumor thrombus. Material and methods Of the 442 patients diagnosed with renal tumors between January 2008 and January 2018, 34 (7.6%) had tumor thrombus over the renal vein extending to the IVC. The data of the 34 patients with tumor thrombus were retrospectively reviewed and included in the study. All the 34 patients underwent radical nephrectomy with tumor thrombectomy. The presence of thrombus was evaluated using contrast-enhanced abdominal tomography, magnetic resonance imaging, or color Doppler ultrasonography. The level of thrombus was classified using the Mayo Clinic tumor thrombus classification. Surgery was performed transperitoneally through a modified Chevron incision and mostly in collaboration with other clinics. Complications were classified according to the Clavien system. Results Of the 34 patients, 22 were males and 12 were females. The mean follow-up period was 36±27.2 months in patients who had a mean age of 61±10.9 years. The mean tumor size was 10.5±3.3 cm. The number of patients according to the thrombus levels I, II, and III were 20, 9, and 5, respectively. The average blood loss was 744±285.4 mL. Radical surgery for all patients who had direct invasion to the vena cava wall and/or level II and III was performed by gastrointestinal and cardiothoracic surgeons. Cardiopulmonary bypass was not performed in any patient. Minor complications (Clavien grades 1-2) were seen in 8 (23.5%) patients, while 2 (5.8%) patients had major complications (Clavien grades 3-5). The mean follow-up period was 36 months (range, 6-72 months). The overall 5-year survival rate was 85.2%. Conclusion We think that radical nephrectomy and caval thrombectomy is a safe and effective method in patients with RCC without tumor exceeding the diaphragmatic level. We believe that the surgical success rate can be increased using a multidisciplinary approach in selected cases.

The correlation between systemic inflammatory markers and malignancies has been assessed by a number of recent studies. The aim of this study was to prospectively assess preoperative inflammation markers and Glasgow prognostic scores (GPS) in patients who underwent surgery for primary bladder cancer (BC), and evaluate the predictive value of GPS for disease recurrence and progression. A total of 38 patients (mean age, 60.16±9.71 years; range, 33–76 years) who were treated in our department between May, 2014 and August, 2015 were enrolled in the present study. Preoperatively, patient information regarding gender, body mass index, serum C-reactive protein (CRP) and albumin levels, GPS and comorbidities, were collected and recorded. Transurethral resection of the bladder was performed, followed by histopathological evaluation of the resected material. The tumor size, stage and grade and the presence of necrosis were determined. According to the international TNM classification, the results of the histopathological analysis were as follows: Ta low- (n=24) and high-grade (n=4); and T1 low- (n=2) and high-grade (n=8). The median follow-up period was 10.1 months (range, 6–12 months). During this period, recurrence was observed in 10 cases and disease progression was detected in 1 patient. Hypoalbuminemia was encountered in 40% of the cases with recurrence, which was significantly higher compared with that in patients without recurrence (7.1%; P=0.031). In patients who had recurrence, a GPS of 1–2 points and tumor necrosis were more frequently detected compared with those without recurrence (60 vs. 7.1%, P=0.002; and 80 vs. 7.1%, P=0.001, respectively). Excluding a cystectomized case with a diagnosis of muscle-invasive BC, disease progression was not detected in any of the cases with recurrence during follow-up. Therefore, we consider that GPS and serum markers of systemic inflammatory response may be used as predictors of recurrence in patients with transitional cell BC.

Renal cell carcinoma (RCC) constitutes 2-3% of all types of cancers. RCCs metastasize into lungs (50–60%), lymph nodes (36%), bones (30–40%), liver (30–40%), and brain (5%) in respective percentages. RCC rarely metastasizes into ovary. Only 25 cases of ovarian tumor, which metastasized into kidneys, have been presented. In the literature, a kidney-ovary axis has been defined, and its interrelationship begins with embryological life. With this case report, we aimed both to present a very rarely seen metastasis of RCC into contralateral ovary and also to review the literature.

Objective: Retropubic radical prostatectomy (RRP) is still widely used in clinical practice in localized prostate cancer because of its high oncological success. The aim of this study was to define the continence status in patients where rhabdosphincter was included in the vesicourethral anastomosis. Materials and methods: Between November 2004 and September 2010, 90 cases who underwent RRP by the same surgeon in our clinic were taken into the study. In all cases vesicourethral anastomosis was performed include the rhabdosphincter. The anastomosis was performed with mean 2.9 (0-7) interrupted no 2-0 vicryl sutures, depending on the angulation of symphysis pubis and pelvic cavity. Pad test was performed to all patients at 1, 3, 6 and 12 months postoperatively. We defined patients as ‘continent’ when they no need pad, as ‘mild incontinence’ when they use only one pad daily, as ‘moderate incontinence’ when they use two or three pads daily and as ‘severe incontinence’ when they use more than three pads daily. Results: Preoperative total PSA value was 12.2 ng/ml (range: 2.7-84 ng/ml). Preoperative prostate biopsy results were found that Gleason scores were 5, 6, 7 and 8 in 7, 53, 21, 9 patients, respectively. Mean operation and urethral catheter removal time was 103 minutes (60-200) and 14,6 days (9-28), respectively. Mean hospital stay was 4.6 days (2-20). According to results of postoperative pad tests, 38 (42.2%), 48 (53.3%), 55 (61.1%) and 75 (83.3%) patients were defined as continent in first, third, sixth and twelfth months, respectively. Conclusions: We think that, our novel technique of vesicourethral anastomosis in standard RRP provides more optimal urethral position during fixation of pelvic floor and urethra, protect caudal retraction, preserve functional urethral length. Also strong full thickness stitch on urethra provides better urinary continence by hanging urethra in our patients. Although our early continence rate is better, our long term continence rate is similar to literature.

Objective To explore the diagnostic importance of translabial ultrasonographic data in incontinence, for comparison with urodynamic data. Material and methods The study was performed between January and May 2017 on 64 patients aged between 40 and 65 years with complaints of mixed type incontinence. The patients were separated into two groups according to their urodynamic data. Translabial ultrasonography was performed in both groups. Results Mean age of the patients was 51.19±7.01 years, and mean body mass index was 26.69±2.02 kg/m2. The patients were separated into two groups as those with (n=33) or without (n=31) stress urinary incontinence based on urodynamic findings (despite the presence of mixed urinary incontinence complaints, stress urinary incontinence and detrusor overactivity associated with incontinence could not be detected in the urodynamic study). Average x descend, y descend and bladder neck mobilization values detected with translabial ultrasonography were found to be statistically significantly higher in the urodynamic stress incontinence group. There was an opposite-directional, 37.6% and statistically significant relation between maximum cystometric capacity and x descend parameters. Y descend values and bladder neck mobilization of females with negative Q-tip test were found to be statistically significantly lower than females with positive Q-tip test. Conclusion As a complementary examination tool in the evaluation of urinary incontinence translabial ultrasonography may become one of the main diagnostic evaluation tools in the future.

Kaposi's sarcoma (KS) is an inflammatory vascular tumor, which can be seen at multiple areas in the body, especially at skin and extremities, mostly in immunosuppressed patients like organ receivers and AIDS patients. It can also be seen in human immune deficiency virus (HIV) negative, heterosexual, circumcised and non-immunosuppressed patients; and the disease course may be very variable. Herein, we present three patients who were referred to our clinic in the last five years and had a rather different course of disease; they were heterosexual, circumcised, non-immunosuppressed, and HIV negative. KS should be kept in mind in nonspecific penile lesions even if the patient is HIV negative. KS has a high recurrence rate even with any kind of treatment. More studies are needed for determining true recurrence rates, treatment plans and any underlying diseases.

The first urological international organization occurred in Paris in 1908, and three Ottoman urologists were present among a total of 29. In that year, the Ottoman Urological society had only nine urologists, and almost all were from the Ottoman minorities with the exception of two under the main branch of General Surgery. Among them, Cemil Pasha who was the first dean and department chief of Surgery and Urology of the Medical School in a modern manner (1909) was the most dominant pioneer of the Turkish Surgery-Urology. Four beds out of 20 were separated for the urology clinic.

Medical expulsive therapy (MET) is used especially in distal ureteral stones to reduce colics and decrease the number of endourological surgical interventions. A broad spectrum of agents can be used for the relaxation and the dilatation of the ureter, reducing the intraureteric pressure. Alfa-blockers, calcium channel blockers, phosphodiesterase (PDE) inhibitors, and spasmolytics have been shown as effective in clinical trials on urolithiasis. It is a fact that the urothelium itself, the interstitial cells and the ureteric smooth muscle, have B-beta-2 and beta-3 adrenoreceptors. Stimulation of these receptors results in relaxation of the ureter. A recent beta-3 agonist, mirabegron, is commonly used for overactive bladder nowadays. The mechanism of action is adrenergic agonism that affects with the storage phase of the bladder, without interfering the voiding phase, which is regulated by parasympathetic pathways, commonly muscarinic. Agonism of the beta-3 receptors in the ureter has been shown to decrease the intraluminal pressure. By this mechanism, mirabegron can be thought as an alternative MET agent. Acting through different pathways, and having low adverse effect profile, can be thought as the most striking advantages of mirabegron as a MET. In vitro and in vivo trials should be conducted to support this hypothesis.

OBJECTIVE: Germ-cell neoplasia in situ (GCNIS) is accepted as the precursor of the testicular tumors. The aim in our study is to compare the lymphadenopathy and metastasis parameters in patients diagnosed with testicular tumor with or without GCNIS based on pathological evaluation. MATERIAL AND METHODS: Data from 108 patients who underwent orchiectomy for testicular tumor between January 2007 and December 2014 in our clinic were retrospectively analyzed and included in the study. Patients were divided into two groups based on the pathology reports as GCNIS or not. Groups were compared regarding lymphadenopathy, metastasis, tumor marker levels, tumor size, lymphovascular invasion, rete testis invasion. Mann-Whitney U test was used for statistical evaluation. RESULTS: Mean age of the patients included in the study were calculated as 34.6±9.3 years. Eighty-five (78.7%) patients had GCNIS, while 23 (21.3%) of them had not. In terms of metastasis, lymphadenopathy, marker levels, tumor size, lymphovascular invasion and rete testis invasion, no statistical significant difference were observed between two groups (p>0.05). CONCLUSION: In our study, no statistical significant difference was observed on the prognostic factors concerning the GCNIS entity, which is reported frequently in testicular tumor pathologies. For presently these findings show us that GCNIS cannot be used as a prognostic factor.

To predict prostatic carcinoma using a logistic regression model on prebiopsy peripheral blood samples.Data of a total of 873 patients who consulted Urology Outpatient Clinics of Fatih Sultan Mehmet Training and Research Hospital between February 2008 and April 2014 scheduled for prostate biopsy were screened retrospectively. PSA levels, prostate volumes, prebiopsy whole blood cell counts, neutrophil and platelet counts, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), biopsy results and Gleason scores in patients who had established diagnosis of prostate cancer (PCa) were evaluated.This study was performed on a total of 873 cases, with an age range 48-76 years, divided into three groups as for biopsy results. with diagnoses of benign prostatic hyperplasia (BPH) (n=304, 34.8 %), PCa (n=265, 30.4%) and histological prostatitis (n=304; 34.8%). Intra- and intergroup comparative evaluations were performed. White blood cell and neutrophil counts in the histological prostatitis group were significantly higher than those of the BPH and PCa groups (p=0.001; p=0.004; p0.01). A statistically significant intergroup difference was found for PLR (p=0.041; p0.05) but not lymphocyte count (p0.05). According to pairwise comparisons, PLR were significantly higher in the PCa group relative to BPH group (p=0.018, p0.05, respectively). Though not statistically significant, higher PLR in cases with PCa in comparison with the prostatitis group was remarkable (p=0.067, and p0.05, respectively).Meta-analyses showed that in patients with PSA levels over 4 ng/ml, positive predictive value of PSA is only 25 percent. Therefore, novel markers which can both detect clinically significant prostate cancer, and also prevent unnecessary biopsies are needed. Relevant to this issue in addition to PSA density, velocity, and PCA3, various markers have been analyzed. In the present study, PLR were found to be the additional predictor of prostatic carcinoma.

Objective To compare the effect of phosphodiesterase inhibitors and physical exercise alone in patients with erectile dysfunction (ED). Materials and methods A total of 60 patients with a satisfactory cardiopulmonary performance who consulted the outpatient clinics of Urology and Physical Therapy and Rehabilitation were included in the prospective study. In the study, 30 patients were scheduled for 6 weeks of vigorous aerobic exercise program to be carried out for 75 min a day, 3 days a week. The remaining 30 patients received only an oral form of a phosphodiesterase inhibitor. All patients completed International Index of Erectile Function (IIEF) and quality of life (SF-36) forms before and after the treatment. Results Median age of the patients was 55.63 ± 12.93 years with body mass index ranging between 18.99 and 35.86 kg/m2. A statistically significant increase has been observed for IIEF-5 and SF-36 scores both in the physical exercise and medical treatment groups. However, in the medical treatment group post-treatment variation in IIEF-5 and SF-36 mental scores in the medical treatment group were statistically significantly higher when compared with the physical exercise group. Increase in physical SF-36 scores in the physical exercise group was more prominent without any statistically significant difference between groups. Conclusion Emerging evidence indicates that exercise has a positive effect for improving many factors in men with erectile dysfunction including changes in body composition, physical function, risk of comorbid conditions, depression, quality of life and an increase in pelvic oxygenation and penile blood flow, and thus before or during the treatment with a phosphodiesterase inhibitor, regular physical activity should be recommend for all ED patients.