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Objectives: To evaluate more comprehensively the presence of an association between childhood lower urinary tract symptoms and development of adulthood overactive bladder, to determine the group at most risk of overactive bladder in adulthood, and to assess its effects on daily life. Methods: A total of 264 patients who were followed up for lower urinary tract symptoms in childhood between 2000 and 2005 were included in this retrospective, cohort study. After a median period of 20 years, these patients with a median current age of 29 (27–35) years were re‐evaluated and divided into two groups: those currently with overactive bladder (n = 102, 23.0%), and those without overactive bladder (n = 162, 36.5%). In addition, 180 age‐matched overactive bladder patients without a history of childhood lower urinary tract symptoms (n = 180, 40.5%) were included. The primary endpoint was to determine which children are at higher risk of adulthood overactive bladder. The secondary endpoint was to evaluate the effect of history of childhood lower urinary tract symptoms on quality of life in adulthood. The eight‐item Overactive Bladder questionnaire, the Pittsburgh Sleep Quality Index, and the Short‐Form 36‐item Health Survey were administered to all participants. Voiding Dysfunction Symptom Score was evaluated according to childhood medical records. Results: Overactive bladder in adulthood was observed in 38.6% of patients recovering from childhood lower urinary tract symptoms. They had worse overactive bladder symptom scores and quality of life than those without childhood lower urinary tract symptoms (P < 0.001). Voiding Dysfunction Symptom Score ≥13 (odds ratio 2.54), daytime incontinence (odds ratio 2.01), holding maneuvers (odds ratio 1.82), nocturnal enuresis (odds ratio 1.75) in the pediatric period, and recovery age from all these symptoms of ≥12 years (odds ratio 1.95) were the most unfavorable determinants of development of adulthood overactive bladder. Conclusions: Our findings show that children with the above characteristics are at risk of developing overactive bladder later in their lives even if their symptoms improve in childhood. [ABSTRACT FROM AUTHOR]

Objective: The incidence of non-urothelial bladder cancers is very low, so our knowledge about their treatment protocols and prognosis is limited. We evaluated the clinicopathological characteristics of 26 patients in three different clinics and aimed to determine the prognostic factors affecting oncological outcomes. Materials and Methods: Between January 2012 and October 2019, we retrospectively analyzed the data of twenty-six patients aged between 44-75 years who were diagnosed and treated due to non-urothelial bladder carcinomas in three clinics. Results: Among twenty-six cases, nineteen (73.1%) were male and seven (26.9%) were female. The mean age at diagnosis was 60.77±8.52. The most common presenting complaint was gross hematuria (84.6%). It was followed by lower urinary tract symptoms (38.4%). Histological types of tumors were squamous cell carcinoma (9 cases, 34.8%), adenocarcinoma (eight cases carrying different histopathologic subtypes: Mucinous, signet ring cell, plasmacytoid/signet ring cell mixed variant and signet ring cell containing osteoclast-like giant cell, 30.8%), small cell carcinoma (3 cases, 11.5%), large cell neuroendocrine carcinoma (2 cases, 7.7%), extra-gastrointestinal stromal tumor (1 case, 3.8%) and malignant undifferentiated mesenchymal tumor (1 case, 3.8%) and leiomyosarcoma (2 cases, 7.6%). At a median follow-up of 13 (2-42) months, the progression-free survival rate was 61.5%, while the overall survival rate was 46.1%. In Kaplan-Meier analysis, the median survival of all cases was found to be 16 (9-33) months. Overall survival times were lower in the presence of advanced (3-4) pathological stages (p=0.006) and higher (≥2) ECOG scores (p=0.005). Conclusion: In our cases, we observed that overall survival rates increased in patients undergoing multimodal treatments involving radical cystectomy compared to the bladder-sparing approach. The survival rates were higher in squamous cell carcinomas, while the rate of metastasis was higher in adenocarcinoma and neuroendocrine tumors. Up-staging rates after cystectomy were higher in adenocarcinomas, sarcomas and squamous cell carcinomas. [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. [ABSTRACT FROM AUTHOR]

We aimed to investigate the association between erectile dysfunction and severity of cardiovascular morbidity and to assess clinical responses to tadalafil of patients in different cardiovascular risk groups. Between November 2019 and August 2020, a total of 258 male patients aged 45–70 years with ED were included. They were divided into three groups according to the Framingham risk score: low‐risk (n: 86, 33.3%), intermediate‐risk (n: 103, 39.9%) and high‐risk (n: 69, 26.8%). At admission, all domains of the International Index of Erectile Function score were worse in high‐risk group compared to other risk groups (p <.001). After a 12‐week follow‐up, a more significant improvement was observed in all domains of erectile function in all risk groups, but high‐risk group had lower sexual scores (p <.001). The lowest rate for complete responsiveness to tadalafil was observed in the high‐risk group (37.7%). The rate of failure in complete responsiveness was found to be 4.127 times greater with higher Framingham score and 3.102 times greater with higher erectile dysfunction severity at admission. Our preliminary findings show that more severe sexual disorders are observed in high‐risk patients with cardiovascular morbidity. Individualised treatment may be important in high‐risk group since they may benefit less from tadalafil, and failure in complete responsiveness can be more common in this group. [ABSTRACT FROM AUTHOR]

Objective: The incidence of bilateral testicular germ cell tumours (TGCT) is low and constitutes 0.5%-7% of all testicular tumours. We aimed to evaluate the clinical and pathological features of unilateral and bilateral TGCT, as well as prognostic factors in bilateral cases that may have an impact on oncological outcomes. Materials and Methods: Bilateral TGCT were detected in 10 (11.4%) of 87 patients between January 2010 and July 2016. Patients with 68 unilateral and 10 bilateral tumours (4 synchronous, 6 metachronous) had completely accessible data. We retrospectively evaluated their clinical-pathological data and postoperative follow-up results. Results: Four patients with bilateral synchronous tumours had a seminoma and three (75%) of them had a stage III disease. At a median follow-up of 31.50 (29-37) months, local recurrence, distant metastasis and death were observed in two patients with stage III disease. No recurrence or metastasis was seen in six patients with unilateral TGCT at 33 (24-50) months of follow-up, but metachronous tumours occurred in the contralateral testicles. At a median follow-up of 25 (11-39) months after metachronous tumour development, local recurrence, distant metastasis and death were observed in the contralateral testis of patients with stage III disease. There was no significant difference in bilateral and unilateral cases for disease-free survival, progression-free survival (PFS) and overall survival (OS). PFS and OS were significantly shorter (p=0.039) in bilateral synchronous tumours than in metachronous tumours. Moreover, stage III disease was more common (75% vs 33.3%) in synchronous tumours. Family history (OR: 6.556, p=0.035), testicular dysgenesis syndrome (OR: 3.876, p=0.031), disorders of semen parameters (OR: 2.879, p=0.037), undescended testis (OR: 2.561, p=0.026), monocyte/lymphocyte ratio >0.31 [odds rotio (OR): 2.234, p=0.022], testicular microlithiasis (OR: 2.015, p=0.015) and neutrophil/lymphocyte ratio >3.23 (OR: 1.348, p=0.025) increased the risk of contralateral tumour development. Conclusion: Bilateral synchronous tumours are detected at a more advanced stage and have lower PFS and OS durations, but survival rates are similar to those of unilateral tumours. Long-term follow-up is necessary for patients with unilateral TGCT having certain risk factors due to the possibility of metachronous tumour development in the contralateral testis. [ABSTRACT FROM AUTHOR]