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Objective: The aim of this study is to evaluate current urologic practice regarding the management of priapism in Turkey and compare with international guidelines. Methods: Urologists and urology residents were invited to an online survey consisting of 30 multiple-choice questions on priapism-related clinical practices that were considered most important and relevant to practices by using Google Forms. Results: Total number of responses was 340. Respondents reported that they recorded a detailed patient's medical history and physical examination findings (n = 340, 100%) and laboratory testing, which includes corporal blood gas analysis (n = 323, 95%). Participants announced that they performed Doppler ultrasound for 1/4 cases (n = 106, 31%), but 22% of the participants (n = 75) replied that they performed in >75% of cases. Participants (n = 311, 91%) responded that the first-line treatment of ischemic priapism is decompression of the corpus cavernosum. Moreover, most respondents (n = 320, 94%) stated that sympathomimetic injection drugs should be applied as the second step. About three-quarters of respondents (n = 247, 73%) indicated adrenaline as their drug of choice. Phosphodiesterase type 5 inhibitors seems to be the most preferred drug for stuttering priapism (n = 141, 41%). Participants (n = 284, 84%) replied that corpora-glanular shunts should be preferred as the first. A large number of participants (n = 239, 70%) declared that magnetic resonance imaging can be performed in cases with delayed (>24 hours) priapism to diagnose corporal necrosis. Most of the participants (84%) responded that penile prosthesis should be preferred to shunts in cases with delayed (>48 hours) priapism. Conclusion: It would be appropriate to improve the training offered by professional associations and to give more training time to the management of priapism during residency. [ABSTRACT FROM AUTHOR]

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Background: To classify intraoperative and postoperative complications using the modified Clavien classification system (MCCS) and modified Satava classification system (SCS) and to evaluate the parameters associated with complications in patients undergoing retrograde intrarenal surgery (RIRS) for renal and proximal ureteral stones. Materials and Methods: We performed a retrospective analysis of 949 patients who underwent RIRS for renal stones and proximal ureteral stones at two institutions between March 2015 and June 2020. Intraoperative complications were assessed using the SCS, and postoperative complications were graded according to the MCCS. Univariate and multivariate analyses were undertaken to determine predictive factors affecting complication rates. Results: The median stone size was determined as 13 mm (range 10–20 mm). The stone-free rate was 83.6% after the first intervention. Reprocedure was applied to 89 of the patients with residual stones and the final stone-free rate was 94.4% after reprocedure. According to SCS, the number of intraoperative events and complication incidences was 153 (16.1%). MCCS revealed postoperative complications in 121 (12.8%) patients. Major complications were observed in 18 (1.9%) patients. The rate of complications was higher in patients with renal anomalies (9.9% vs 3.4%, p = 0.001). Stone location, stone size, stone burden, stone number, stone density, and residual fragments were determined to be associated with the development of complications (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p = 0.002, and p < 0.001, respectively). In addition, the multivariate analysis revealed that only the presence of residual fragments was a significant predictor of complication development for the patients with Grade ≥3 complications according to MCCS (p = 0.032). However, significant predictors were stone burden (p < 0.001), stone density (p = 0.002), and fluoroscopy time (p < 0.001) for those with Grade ≥2b complications according to SCS. Conclusion: This study showed that abnormal kidney anatomy, operation time, stone burden, and residual fragments were reliable predictors of complication development during and after RIRS. Appropriate preoperative management should be planned according to these predictors to prevent intraoperative and postoperative complications. [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]