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Objective: This retrospective study reveals whether a lesion is a benign pathological process or malignant by measuring apparent diffusion coefficient (ADC) values following prostate imaging reporting and diagnostic system version 2.1 (PI-RADSv2.1) guide on multiparametric magnetic resonance imaging (MpMRI) examinations. Furthermore, this study aims to determine the cut-off ADC values (ADCv) that may exist to help identify and distinguish between benign and the malignant lesions. Additionally, the paper evaluates whether there is a correlation between malignant lesions' International Society of Urological Pathology (ISUP) score and ADCv, and whether ADCv provide information about prostate cancer (PCa) aggressiveness without requiring invasive procedures. Materials and Methods: The study group consised of 243 patients. The lesions were diagnosed using transrectal ultrasound-guided cognitive MRI fusion. MpMRI images before the biopsy were evaluated according to PI-RADSv2.1 guideline by a radiologist. Three groups, benign prostatic tissue, prostatitis, and PCa were obtained according to the histopathological results. Results: When the cut-off value for ADC was 780x10-3, sensitivity was 80%. When the cut-off value was taken as 668x10-3, the sensitivity and specificity were 72% and 62%, respectively. When the cut-off ADCv was taken as 647x10-3, the sensitivity was 83% and the specificity was 48.5%. ADCv varied significantly depending on the ISUP groups (p=0.003). It was determined that the ISUP 1 group was significantly higher compared to other groups. ADC group mean values were not significantly different between groups 2, 3, 4, and 5. Conclusion: ADCv may be a suitable tool for estimating PCa aggressiveness, and it shows a significant potential to improve the diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Paratesticular masses constitute 2-3% of the scrotal masses. Epididymal masses constitute only 5% of prescrotal masses, and the most common type of tumor is adenotoid tumor, which is benign. Malignancies of the epididymis are rare. Epididymal adenocarcinoma is much less common. It can be primer and metastatic, and there are fewer than 40 cases in the literature in both groups. Primary epididymal adenocarcinoma is extremely rare, with only 23 cases reported. The disease diagnostic process, findings, and treatment are still unknown. In this article, we aimed to present a case of epidimal adenocarcinoma with primary origin from the epididymis. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the effects of lymphovascular invasion (LVI) on survival rate, as well as the relationship of this parameter with lymph node (LN) involvement and other prognostic factors, in patients undergoing radical cystectomy (RC) for bladder cancer. Materials and Methods: Patients who underwent RC in our clinic for muscle invasive bladder cancer (MIBC) or high-risk non-muscle invasive bladder cancer (NMIBC) between 2006 and 2019 were retrospectively reviewed. Patients were divided into four groups: LVI (-) and LN (-) patients were in group 1, LVI (+) and LN (-) patients were in group 2, LVI (-) and LN (+) patients were in group 3, and LVI (+) and LN (+) patients were in group 4. All data were compared among the groups. Results: A total of 177 patients with a mean age of 64.4 years and mean follow-up time of 30.2 months were evaluated in this study. The mean overall survival (OS) and cancer-specific survival (CSS) of the patients were 56.6±4.2 and 68.9±4.5 months, respectively. When factors affecting survival rates were analyzed, LN positivity was not a significant factor influencing the OS (p=0.570) and CSS (p=0.533) of the patients. However, LVI [p=0.002, hazard ratio (HR)=0.402] and surgical margin (SM) positivity (p=0.001, HR=0.321) were significant factors influencing OS. SM positivity (p=0.003, HR=0.314), LVI (p=0.011, HR=0.416), and adjuvant chemotherapy (ACT) (p=0.009, HR=0.460) were also found to be independent factors affecting CSS. ACT was higher in group 3 than in other groups, and overall and cancer-specific mortality rates were lower in group 1 than in other groups. OS and CSS in group 2 (15.3±2.9 and 21.2±4.6 months, respectively) and group 4 (21.5±7.2 and 24.5±8.1 months, respectively) were lower than those in other groups (p<0.001). Conclusion: SM positivity and LVI are independent factors affecting OS and CSS. ACT, especially in group 3, could increase CSS. OS and CSS were lower in patients with LVI than in those without. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to investigate the oncologic outcomes of patients who were diagnosed with primary (muscle invasive cancer at the time of diagnosis) and secondary (cancer that showed progression from non-muscle invasive bladder cancer) muscle invasive bladder carcinoma (MIBC) before radical cystectomy (RC). Materials and Methods: Patients who underwent RC at our clinic for MIBC between July 2008 and June 2017 were included in the study. They were divided into two groups based on their diagnosis as primary and secondary MIBC. Their clinical, pathological, and oncologic data (upstaging, adjuvant chemotherapy, overall mortality, overall survival, cancer-specific mortality, and cancer-specific survival) were evaluated retrospectively. Results: A total of 80 patients underwent RC due to bladder cancer with a mean age of 64.4±7.8 years (range: 42-83 years) and a mean follow-up time of 32.9±32.1 months (range: 1-113 months). The overall and cancer-specific survivals of the patients were 64.7±6.6 and 74±6.8 months, respectively. Sixty-five and 15 patients were evaluated in the primary and secondary MIBC groups, respectively. Lymph node metastasis was higher in primary MIBC group (p=0.031). Although, there were no statistical differences between the groups, in secondary MIBC group, the overall survival (67.3±7.2 months vs 42.5±8.4 months; p=0.835) and cancerspecific survival (77.6±7.4 months vs 46.6±8.6 months; p=0.546) were lower, while the overall mortality (44.6% vs 53.3%; p=0.372) and cancer-specific mortality (32.3% vs 46.7%; p=0.293) were higher compared to primary MIBC group. Conclusion: The pre- and postoperative pathological T stages were similar between the groups, whereas postoperative lymph node positivity was lower for secondary MIBC patients. The mortality was higher and overall and cancer-specific survivals were lower in secondary MIBC patients; however, these findings were not statistically significant. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to evaluate the influence of preoperative hydronephrosis and ureteral orifice involvement (UOI) on survival of patients undergoing radical cystectomy (RC) for bladder cancer (BC). Material and methods: A total of 162 patients with BC underwent RC between January 2006 and March 2017. Patients were divided into two groups for both presences of preoperative hydronephrosis and orifice involvement at final pathology. Additionally, tumors with orifice involvement were subgrouped histopathologically after RC as those with only UOI and those with invasive to the ureter with an additional concurrent site at final pathology. Results: Preoperative hydronephrosis was detected in 57 patients. Preoperative and postoperative creatinine on month 3 were higher in the preoperative hydronephrosis (+) group (p<0.001). In addition, postoperative T stage, surgical margin positivity, invasion of urethra, and pathological upstaging were higher in this group. Cancer-specific survival (CSS) and overall survival (OS) were better in the hydronephrosis (-) group than in the hydronephrosis (+) group (p=0.001 and p=0.001, respectively). Preoperative hydronephrosis was found to be an independent factor in pathological upstaging. Patients were divided into two groups according to the presence of UOI. Group 1 consisted of patients without UOI, and group 2 with UOI. Preoperative hydronephrosis, hydronephrosis grade, and T stage were statistically higher in tumors with UOI. Moreover, CSS and OS were lower in group 2 than in group 1. Conclusion: Preoperative hydronephrosis and UOI are predicting factors on survival of patients undergoing RC for BC. Preoperative hydronephrosis was found to be an independent factor in pathological upstaging. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the influence of preoperative factors on postoperative renal function and the association between renal function and oncologic outcomes and complications after radical cystectomy (RC). Materials and Methods: We retrospectively analyzed patients who underwent RC due to muscle-invasive bladder cancer and intravesical treatmentresistant nonmuscle-invasive bladder cancer in our center between January 2006 and March 2017. The patients' age, gender, comorbidities, preoperative estimated glomerular filtration rate (eGFR), presence of hydronephrosis, hydronephrosis grade and laterality, urinary diversion type, preoperative and postoperative pathology findings, eGFR at postoperative 3rd month, oncologic outcomes, and complication rates were evaluated. The patients were divided into 2 groups based on postoperative eGFR: group 1 (<60 mL/min eGFR) and group 2 (=60 mL/min eGFR), and data were compared between the groups. Results: The study included 125 patients with urothelial carcinoma of the bladder who underwent RC and had complete records (59 patients in group 1 and 66 patients in group 2). Of the preoperative factors, only presence of hydronephrosis was significantly higher in group 1 (p=0.012). There were no statistically significant differences between the groups in terms of urinary diversion type, pathology findings, oncologic outcomes, or complications. Conclusion: Preoperative eGFR and hydronephrosis were significantly associated with postoperative 3rd month eGFR. Postoperative eGFR <60 mL/min was not associated with diversion type, pathologic and oncologic outcomes, or complications. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to examine the usefulness of preoperative neutrophile-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratios to predict pathological upstaging of invasive bladder cancer who underwent radical cystectomy. Material and methods: A total of 126 patients who underwent radical cystectomy at our clinic between January 2006 and March 2015 were retrospectively analysed. One hundred and twelve patients with organconfined invasive bladder tumors (T2) detected at histopathological examination of transuretral resection material were included in the study. Upstaging was seen at histopathological examination of radical cystectomy specimens of 42 patients. We compared preoperative neutrophile-to-lymphocyte ratio, platelet-tolymphocyte ratio, lymphocyte-to-monocyte ratio between upstaged and not-upstaged groups. Results: There were no statistically significant correlation between age, time to radical cystectomy, gender, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio ratios and carcinoma in situ in upstaged and non-upstaged groups. Statistical analyses showed that preoperative neutrophile-to-lymphocyte ratio was higher in upstaged patients (p=0.009). In multivariate analysis preoperative neutrophile-to-lymphocyte ratio and positive surgical margin were significantly higher in upstaged group. Conclusion: In organ-confined muscle invasive bladder cancer neutrophile-to-lymphocyte ratio seems to be an acceptable parameter to predict locally advanced disease. [ABSTRACT FROM AUTHOR]

Copyright of Üroonkoloji Bülteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: In this study, we aimed to investigate the relationship between age and tumor characteristics and to evaluate oncologic results after radical cystectomy in bladder cancer with respect to age. Material and methods: We reviewed 460 patients retrospectively who underwent radical cystectomy. Patients were divided into two groups according to age: >70 (Group 1), and <70 (Group 2). We compared tumor's pathological characteristics and the results of long-term follow-up in both groups. The first group included 76 (16.7%), and the second group 379 (83.3%) patients. The mean age of the patients was 73.3±3.01 years (70-85) in Group 1 and 58.3±7.47 years (34-69) in Group 2. The American Society of Anesthesiologists (ASA) score was less than three in all of the patients, and there was no risk for major surgery. Results: Any statistically significant difference was not found between groups with respect to pathological T stage (p=0.567), lymph node involvement (p=0.179), or histological grade (p=0.567). Perioperative mortality rates were 3.9, and 3.4% for Groups 1, and 2, respectively (p=0.218). Perioperative complication rates were 14.7, and 17.5% for groups 1, and 2 respectively (p=0.578). Five-year disease-specific survival (DSS) rates were 57.0, and 51.6% Groups 1, and 2, respectively. The mean DSS periods were 82.05±4.88 and 71.68±8.53 months for Groups 1, and 2, respectively. Five-year overall survival rates were 43.9% for Group 1 and 45.9% for Group 2. The mean overall survival times were 54.02±8.47, and 69.25±4.97 months for Groups 1, and 2, respectively. In Cox regression analysis, tumor stage (p=0.012) and lymph node involvement (p<0.001) were significant factors that affected the survival in both groups. None of the patients received neoadjuvant radiotherapy or chemotherapy. Conclusion: We found that oncological outcomes of radical cystectomy performed with the indication of bladder tumor were comparable between young and elderly We believe that age per se should not constitute a contraindication for radical cystectomy operations. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Urology is the property of Turkish Association of Urology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The aim of this study was to evaluate the effect of gender on oncologic results in patients who have undergone radical cystectomy due to bladder cancer. Materials and methods: We retrospectively reviewed data from 460 patients who had radical cystectomy due to bladder cancer in our clinic. A total of 420 of the patients were men, and 40 patients were women. We evaluated the tumor type, tumor stage, tumor grade, lymph node involvement status, complications and survival rates of the females. These parameters were compared to male cystectomy data. Results: The median age of male and female patients was 60.59±8.966 and 63.2±7.816, respectively (p=0.076). In total, 79.4% of the males and 70.3% of females had transitional cell cancer (p=0.192). The detection frequencies for pT1, pT2, pT3 vs. pT4 stage tumors in males and females was 18%, 34.2%, 33.4% vs. 14% and 2.8%, 33.3%, 41.7%, 22.2%, respectively. The percentage of the lymph node involvement in female and male patients was 48.5% and 23.9% (p=0.02). The grade 3 tumor involvement in female and male patients was 80.6% and 72.7% (p=0.621). In females, the bladder-confined tumor percentage was 22.2% and males rate was 48.3% (p=0.04). In terms of overall complications, no significant differences were found between males and females. Disease-specific survival (DSS) was 115±42.2 months in males and 18±2.14 months in females. Three-year DSS was 61.4% in males and 15.3% in females (p=0.013). Median overall survival was 47±11.789 months in males and 18±1.581 months in females. Three-year overall survival was 53.2% for males and 11.4% for females. A significant difference was found between males and females (p=0.013). Conclusion: In this study, we found that females present worse disease specific and overall survival rates than males due to poor prognostic factors such as lymph node involvement and the higher prevalence of extravesical disease in female patients. [ABSTRACT FROM AUTHOR]

Objective: In this study, we investigated the relationship between prostate size and age with prognostic factors in patients who underwent transrectal ultrasonography-guided (TRUSG) prostate biopsy because of high prostate specific antigen (PSA) values. Materials and methods: A total of 1133 patients underwent 10-quadrant TRUSG-guided prostate biopsy due to high PSA values at our clinic between 2001-2012. Cases with prostate cancer were divided by age and prostate size. Patients were classified into 3 groups according to age (<60, 60-70 and >70 years) and prostate size (<40 cc, 40-70 cc and >70 cc). We evaluated the relationship between prostate size and age with prognostic factors in patients with diagnosed prostate cancer. Cases with prostate cancer classified according to age were compared in terms of PSA, PSA density, Gleason score, positive core percentage, average highest positive core tumor percentage and perineural invasion. Cases classified according to prostate size were compared in terms of PSA, Gleason score, positive core percentage, average highest positive core tumor percentage and perineural invasion. Results: A total of 1133 patients underwent prostate biopsy. Prostate adenocarcinoma was detected in 326 patients (28.7%), and benign prostate hyperplasia was detected in 808 (71.3%) patients. The detection rate of prostate cancer in patients <60 years of age and >70 years of age was 13.2% and 40.7%, respectively (p<0.001). The prostate cancer detection rate in patients with a prostate size <40 cc and >70 cc was 39.2% and 16.1%, respectively (p<0.001). PSA, PSA density, Gleason score, positive core percentage, average highest positive core tumor percentage and perineural invasion were increased significantly in older prostate cancer patients (p<0.05). Although PSA increased with prostate size (p<0.001), Gleason score, positive core percentage, average highest positive core tumor percentage and perineural invasion were not correlated with prostate size. Conclusion: While the detection rate of prostate cancer increased with age, a negative correlation was observed with prostate size in patients who underwent prostate biopsy due to high PSA values. It was clear that poor prognostic factors were related to age, but that was not shown with prostate size except for PSA. Prostate cancer detection rate was lower in younger patients who underwent prostate biopsy due to high PSA levels. Therefore, non-cancer causes of elevated PSA and the use of PSA derivatives should be considered to increase the detection rate of cancer in these patients. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Urology is the property of Turkish Association of Urology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Primary lymphoma of the prostate is a rare condition, representing 0.09% of prostatic malignancies. The clinical presentation of malignant lymphoma of the prostate is difficult to distinguish from other prostatic diseases. Systemic symptoms are rare. Treatments include surgery, chemotherapy and/or radiotherapy. We report a case of primary lymphoma of the prostate in a male patient who presented with lower urinary tract symptoms. [ABSTRACT FROM AUTHOR]

This study was aimed to identify the most frequently observed pathogens in uncomplicated urinary tract infections from outpatient urinary isolates obtained across seven different geographical regions in Türkiye and to determine whether the antibiotic resistance rates of these pathogens differ significantly between these regions. The study included patients aged 18 to 65 years who were diagnosed with uncomplicated urinary tract infections and had positive urine cultures from March 2021 to August 2022, across 37 different centers in Türkiye. The participating centers were selected based on their use of the disk diffusion method, in line with the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines, to ensure standardization of urine culture data. A total of 1850 patients who met the inclusion criteria were included in the study. The analysis of the distribution of antibiotic resistance rates in Escherichia coli isolates revealed statistically significant differences in resistance to ampicillin, fosfomycin and nitrofurantoin across different regions (p< 0.05, p< 0.05, p< 0.05, respectively). The Southeastern Anatolia region was identified as having the highest resistance rates to fosfomycin and trimethoprim-sulfamethoxazole (27.4% and 35.3%, respectively). Additionally, the region with the highest nitrofurantoin resistance was determined as the Eastern Anatolia Region with a rate of 35.7% and the region with the highest ciprofloxacin resistance was determined as the Central Anatolia Region with a rate of 51%. Our study demonstrated that antibiotic resistance in the treatment of uncomplicated urinary tract infections varies by geographical region. We believe this comprehensive, national prospective study will provide valuable insights for clinicians planning empirical treatment for uncomplicated urinary tract infections.