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To assess the incidence, risk factors, and timing of specific causes of reoperations following PVP. A retrospective analysis of data on men who underwent GreenLight PVP between 2004 and 2019 in a single center and required surgical intervention for bladder neck contracture (BNC), urethral stricture (US), or persistent/recurrent prostate adenoma. The overall rate of reoperations was 13.8% during a 61-month median follow-up of 377 patients. Reoperations were due to BNC, US, and adenoma in 7.7%, 5.6%, and 4.8% of cases, respectively. The median interval until reoperation for US (11 months) was significantly shorter. None of the risk factors had any relevance to US. In patients who underwent reoperation for BNC, lasing time and energy were significantly lower, and the prostate volume was smaller; however, the multivariate analysis only identified shorter lasing time as a predictor. In patients who had reoperation for persistent/recurrent adenoma, the PSA was increased, while the prostate volume was non-significantly high, and performance by less-experienced surgeons was associated with a higher rate of reoperations (p < 0.05). A longer lasing time predicted an increased risk of reoperation for adenoma in multivariate analysis. An unselective utilization of PVP may result in a relatively high rate of reoperations. The correlation of BNC with shorter lasing time may imply a higher risk after PVP of smaller prostates. A longer lasing time predicts an increased risk of reoperation due to persistent/recurrent adenoma, which may be related to higher prostate volumes and inefficient PVP by less-experienced surgeons. [ABSTRACT FROM AUTHOR]

Objective: To evaluate clinicopathological features of patients with serum prostate-specific antigen (PSA) level of ≤3 ng/mL and diagnosed with prostate cancer (PCa). Materials and Methods: A total of 34 male patients diagnosed with PCa by either prostate needle biopsy (PNB) or transurethral resection of the prostate (TUR-P) were included in this study between January 2010 and June 2021. Patients whose preoperative serum PSA level was >3 ng/mL and those with missing clinical data were excluded. Preoperative clinical characteristics of the patients and pathological findings of PNB, TUR-P, and radical prostatectomy (RP) specimens were evaluated. Results: The median age of the patients was 65 (60-69) years. The median preoperative serum PSA level was 1.98 (1.45-2.64) ng/mL. PCa was detected by "systematic prostate biopsy (SBx) only", combined prostate biopsy [SBx following multiparametric magnetic resonance imaging-targeted prostate biopsy (TBx)], and "TUR-P" in 6 (17.6%), 17 (50.0%), and 11 (32.4%) patients, respectively. In combination of both biopsy, PCa was detected in "SBx specimens only", "TBx specimens only", and "both TBx and SBx specimens" in 3 (8.8%), 5 (14.7%), and 9 (26.5%) patients, respectively. Clinically significant (cs) PCa was in 52.9% of the TBx (9/17) and 60.9% of the SBx (14/23) specimen. Twenty (58.8%) patients treated with RP. csPCa in RP specimens was observed in 17/20 (85.0%) patients. Upgrading in RP specimens compared with PNB specimens was observed in 5/11 (45.5%) of the TBx and 9/17 (52.9%) of the SBx specimen. At the final RP pathology, International Society of Urologic Pathology-grade group >3 or non-organ confined disease were observed in 8 (40%) and 8 (40.0%) patients, respectively. Conclusions: Adverse pathological outcomes in RP specimens are frequent in patients with PCa with a serum PSA level of ≤3 ng/mL at the time of diagnosis, and physicians should be aware of the limitations of pre-set PSA cut-off levels. [ABSTRACT FROM AUTHOR]

Cancer remains a major health issue and our understanding of its etiopathogenesis needs to be improved. Cancer cells have specific abilities such as uncontrolled proliferation, differentiation, progression, and metastasis. Improved interpretation of intracellular molecular pathways and the development of new genetic or immunological diagnostic techniques have facilitated novel treatment modalities for cancer. These therapeutic agents generally have antiproliferative properties and regulate molecular mechanisms on the intracellular pathways. Small molecule inhibitors, monoclonal antibodies, and some gene-editing treatments have been suggested due to the discovery of new molecular mechanisms. However, limited and transient efficacy, and drug resistance generated by mutations are among the disadvantages of these treatments. Multi-functional inhibitors have highly side effects, but benefit from greater efficacy and evading resistance while the recent specific inhibitors possess increased potency and less toxicity. Furthermore, the combination of therapeutic modalities may potentiate the outcome. Considering the actual literature, this review summarized targeted therapies for treating cancer patients in urology as an overview. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the correlation between index lesion prostate imaging-reporting and data system (PI-RADS) version-2 score and histopathological outcomes of prostatectomy specimens. Materials and Methods: A total of 78 male patients with prostate cancer (PCa) treated with robot-assisted radical prostatectomy between August 2015 and June 2020 were included in this study. In this cohort, suspicious lesions on multiparametric magnetic resonance imaging (mpMRI) were scored according to PI-RADS version-2 criteria. MpMRI-targeted prostate biopsy was performed for all suspicious lesions with a PI-RADS score of =3 followed by systematic prostate biopsy. The relationship between index lesion PI-RADS score and histopathological outcomes of prostatectomy specimens were evaluated statistically. Results: The mean age of the patients was 65.0±7.0 years. The distribution of PI-RADS scores of 3, 4, and 5 of the index lesions were 6 (7.7%), 29 (37.2%), and 43 (55.1%), respectively. Lower tumor volume and tumor volume ratio were observed in patients with a PI-RADS score of 3 when they were compared with patients with PI-RADS scores of 4 and PI-RADS-5 (p<0.001, for each). No significant correlation was found between index lesion PI-RADS score in mpMRI and clinically significant PCa in prostatectomy specimens (r<0.200, p>0.05). However, a significant correlation was observed between index lesion PI-RADS score and extracapsular extension (ECE), as well as seminal vesicle invasion (SVI) and pT stage (r=0.327, p=0.004; r=0.276, p=0.014, r=0.348, p=0.002, respectively). Conclusion: Increased index lesion PI-RADS scores were associated with ECE, SVI, higher tumor volume, tumor volume ratio, and pT stages. Increased index lesion PI-RADS score in mpMRI may be helpful in prediction of locally advanced PCa in prostatectomy specimens. [ABSTRACT FROM AUTHOR]

This case report aimed to review the literature on translocation renal cell carcinoma (tRCC), which is a rare form of kidney cancer and was the initial diagnosis of a recently treated patient. We report our findings in a 30-year-old female who underwent robot-assisted radical nephrectomy for an incidental right renal mass, which was reported as unclassified RCC at final pathologic evaluation after eliminating tRCC as differential diagnosis, and discuss the main aspects of tRCC based on current literature. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to determine genetic expression levels of vascular endothelial growth factor (VEGF) and thrombospondin-1 (TSP-1) in fresh bladder tumor specimens and evaluate their relationship with tumor histopathological features and their prognostic value in recurrence and progression in patients with bladder cancer. Materials and Methods: Patients who were treated for urothelial cancer of the bladder and followed for at least 6 months were included in this retrospective study. Following RNA isolation from fresh tumor tissue samples recovered from transurethral resection or radical cystectomy specimens, VEGF and TSP-1 mRNA expression was analysed by reverse transcription polymerase chain reaction (RT-PCR). The findings were examined in relation to the histopathological parameters and recurrence and progression rates of the respective tumors. Results: Sixty-eight patients were included in the study. Mean follow-up time was 22.6 months. In patients with non-muscle-invasive urothelial bladder cancer (NMIBC), rates of recurrence and progression were 64% and 35%, respectively. RT-PCR analyses revealed VEGF mRNA expression in 29 patients (43%) and TSP-1 mRNA expression in 22 patients (32%). Recurrence and progression were observed during follow-up in 64% and 24% of the 25 NIMBC patients with positive VEGF expression, while these rates were 63% and 30% among the 30 NIMBC patients with no VEGF expression, respectively. Rates of recurrence and progression during follow-up were 70% and 30% among NIMBC patients with positive TSP-1 expression and 60% and 26% among patients with no TSP-1 mRNA expression, respectively. Conclusion: In this study, VEGF and TSP-1 mRNA expression was not associated with histological grade or stage of bladder cancer. There was no difference in VEGF expression in tumor tissues from NIMBC patients with or without disease recurrence. Though lacking statistical significance, a positive correlation between TSP-1 expression and tumor recurrence and progression was seen among the NIMBC patients in our study. Although stimulatory and inhibitory factors are known to regulate angiogenesis, no definitive conclusions have been reached regarding their mechanism of action or the prognostic significance of their up-or down-regulation. [ABSTRACT FROM AUTHOR]

Objective: In this study, it was aimed to investigate the success of transperineal multiparametric magnetic resonance imaging (mp-MRI)/ transrectal ultrasonography (USG) fusion prostate biopsy method in prostate cancer diagnosis and detection of clinically significant cancer. Materials and Methods: All patients signed written informed consent then patients with an indication for prostate cancer, therefore biopsy was planned for the last year underwent 3 Tesla mp-MRI retrospectively. All the lesions of patients with Prostate Imaging, Reporting and Data System (PIRADS) 3, 4 and 5 lesions were marked using MIM™ Symphony software by a single radiologist. All patients underwent transperineal MRI/USG fusion biopsy under general anesthesia. In the prostate MRI evaluation of the targeted lesions with a PIRADS score of 3-4-5 were sampled with 2 to 5 cores followed by random biopsies of both of the prostate lobes. Results: Prostate adenocarcinoma was diagnosed in 20 of 59 patients (33.8%) having fusion biopsy. No difference was observed in prostatespecific antigen levels of patients whose biopsy results were benign and malignant. In 63% of patients, only PIRADS 3 lesions were found, whereas PIRADS 4 and/or 5 lesions were reported in 22 (37%) patients. The fusion biopsy of PIRADS 3 lesions revealed cancer in 7 patients (19%), of which 6 had clinically-insignificant prostate cancer criteria. Adenocarcinoma was diagnosed in 59% who had PIRADS 4 and/or 5 lesions. All these tumors had clinically-significant cancer characteristics. Lesion-targeted fusion biopsies missed 1 clinically-insignificant adenocarcinoma (1/7; 14.3%), while it did not miss any of the clinicallysignificant cancers. No infection was seen in post-operative period. Acute urinary retention was developed in 4 patients (6Conclusion: The findings in the initial period give rise to the thought that lesion targeted prostate biopsy method may have a crucial role in especially determining clinically-significant cancer. Prospective randomized studies with larger numbers of patients and especially comparison of different fusion biopsy platforms, are needed in order to assess the diagnostic success of MRI/USG fusion biopsy fully. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the prevalence of simple renal cysts in an adult health-screening cohort, and to evaluate clinical characteristics, associated risk factors and the natural course. Materials and Methods: Between April and November 2008, a thousand individuals diagnosed with simple renal cyst by ultrasonography in a check-up program were chart-reviewed for demographic-clinical characteristics and cyst features. Follow-up was done via electronic patient records. Univariate and multivariate analyses to evaluate the relationship of outcomes and correlation analysis were done to measure the degree of association between parameters. Results: The prevalence was 7.7%. There were 123 cysts in 77 patients, followed for 3.5 years (mean). Individuals with cysts were older (P < .01). Prevalence rates were 2.7% in individuals younger than 40 years and 23.9% in older than 60. The cysts were predominantly (94.8%) detected in males and most (63.6%) were solitary. No relation with Body Mass Index and total cholesterol levels was found but serum creatinine values were significantly increased in individuals with cysts (P < .01). There was no difference in the diagnosis of hypertension and microscopic hematuria in patients with renal cysts, however diabetes/hyperglycemia were more common and increasing age correlated with higher number of cysts (all P < .05). Follow-up revealed that the number of cysts were increased and/or the same in 86.5%; the sizes of cysts were larger and/or the same in 78.4% of patients, while in 14% of patients the cyst disappeared. Conclusion: In a cohort of adults undergoing a health-screening, the prevalence of simple renal cyst was found 7.7% by ultrasonography. Renal cysts were more common in males and elders, and associated with increased levels of serum creatinine and diabetes. [ABSTRACT FROM AUTHOR]