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Introduction: Management of renal stones in children with a solitary kidney is a challenge. In the current study, the efficacy and safety of retrograde intrarenal surgery (RIRS) in these children were determined. Patients and Methods: Records of children with renal stones who were treated at our institute between August 2011 and August 2014 were retrospectively assessed. Inclusion criteria were: Children with single renal stone

Introduction Urosepsis is a significant risk associated with prostate biopsy. Resistance of microorganisms to antibiotics is a challenging issue for clinicians in everyday practice. In the current study, we investigated the rates of sepsis and hospital admissions following transperineal (TP) prostate biopsies using a single dose of gentamicin. Material and methods Data for consecutive patients who underwent TP prostate biopsies (March 2019-March 2020) were included. Patients received a single-dose of prophylactic gentamicin 120 mg IV and had skin preparation with antiseptic povidone-iodine or chlorhexidine solution prior to the procedure. Patient's electronic records were reviewed for rates of sepsis and readmission to hospital within 7 days following TP prostate biopsy. Results A total of 365 consecutive patients were included in the study. After exclusion of non-eligible patients, 280 patients were included in final analysis. The median age was 67 years (32-83), the median prostate-specific antigen (PSA) level was 8.5 ng/ml (0.2-58), and the median prostate size was 44 cc (10-188). Approximately 58% of patients had one or more comorbidities in the form of diabetes mellitus (DM), hypertension, asthma, chronic kidney disease, or ischemic heart disease. Adenocarcinoma was found in 71.7% of patients. None of the 280 patients developed sepsis. Urinary tract infection (UTI) occurred in 2.8% of patients with E.coli, none of them required hospital readmission. Conclusions Our single centre experience showed a 0% sepsis rate after TP prostate biopsy with single prophylactic dose of gentamicin. Future randomized controlled trials (RCTs) should explore the possibility of performing these procedures without antibiotic prophylaxis in order to reduce the unnecessary use of antibiotics. [ABSTRACT FROM AUTHOR]

Objective: The aim of this prospective study was to compare scrotal ultrasonographic findings in obese and normal weight infertile men and correlate these findings with semen parameters and hormonal profile. Material and methods: A total of 188 men presented for infertility evaluation were included in this study. They were divided according to body mass indices into obese (n=96) and normal weight infertile patients (n=92). Basic infertility evaluation, semen analysis and scrotal duplex ultrasound examination in addition to measurement of serum levels of follicular stimulating hormone, testosterone and estradiol were done for all cases. The ratio between testicular size measured by scrotal ultrasound and body mass index were calculated. Results: Any significant differences were not observed in semen parameters, serum levels of follicular stimulating hormone and testosterone between obese and normal weight infertile men (p>0.05). Serum estradiol level was significantly higher in obese than normal weight infertile men (p<0.001). There is signifi- cant increase in subclinical varicocele, hydrocele and testicular microlithiasis detected by scrotal ultrasound in obese infertile men than nonobese patients (p<0.05). Despite having comparable testicular size detected on scrotal ultrasound, infertile obese men had significantly lower total testicular volume to body mass index ratio and this ratio correlated positively with semen volume, sperm concentration, total sperm count and serum testosterone but negatively with serum follicular stimulating hormone and estradiol levels. Conclusion: We therefore conclude that the incidence of subclinical varicocele, hydrocele and testicular microlithiasis was higher in obese infertile patients and the ratio between testicular volume assessed by scrotal ultrasound and body mass index may be a new parameter that correlates with subfertility status in these men. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the stone hardness in predicting the need for single or two sessions of retrograde intrarenal surgery (RIRS) for renal pelvis stones of 2-3 cm in size. Material and methods: Ninety-six patients (64 male and 32 female) with only renal stones (2.5±0.3 cm) underwent RIRS using flexible 7.5 Fr ureteroscope (FURS). The stone hardness was evaluated by preoperative non-contrast computed tomography (NCCT). The patients were divided into two groups based on stone hardness: Group I (n=54) (hard stones - Hounsfeld Unit (HU) >1000) and group II (n=42) (not hard stone - HU <1000). The stone- free rate, the operative time, any intra or postoperative complications and the need for second sessions of RIRS were evaluated. Results: All stones were successfully accessed. Intraoperative complications were not reported. The initial stone- free rate was 40% in Group I and 95% in Group II after a single session (p=0.01). A second session FURS was needed in 32 cases of Group I (40%) where postoperative CT showed significant residual stone fragments of 6±2 mm, and stone-free rate up to 100 percent. On the contrary only 2 cases from Group II underwent second session FURS (p=0.01). The operative times were 75±15 minutes in Group I and 55±13 minutes in Group II (p<0.01). Six patients (4 in group I and 2 in group II) had postoperative high- grade fever (Clavien Grade II). Conclusion: Stone hardness had a significant impact on the decision of performing single versus two sessions of FURS for renal pelvic stones of 2-3 cm rather than the stone size alone. [ABSTRACT FROM AUTHOR]

Aim Over the past few years, we have been doing an increasing number of revisions for artificial urinary sphincters (AUS) at our center. The study aims to investigate reason for this change in our practice. Methods Demographics and surgical outcomes of patients who received AUS in 2003-2014 at our center were retrospectively evaluated, and patients were contacted to check the current status of their AUS. The outcomes of the study were: percentage of revisions and explanation, survival, and the risk factors associated with these events. Results A total of 102 patients (72 years (30-87)) underwent 214 procedures: 99 primary implants, 11 secondary implants, 84 revisions, and 20 explantations-median follow-up was 54 months (5-146). The 5-years and 10-years revision-free survival for AUS were 47% and 23%, respectively. The 5 and 10 years explantation-free survival were 77% and 72%, respectively. The median time to revision for AUS implanted in 2010-2014 was shorter than in AUS implanted in 2003-2009 (6 vs. 13.5 months, P = 0.08). The percentage of AUS that were preceded by urethral surgery for incontinence was significantly higher in AUS implanted in 2010-2014 than in those implanted in 2003-2009 (19% vs. 63%, P = 0.001). The percentage of patients with AUS who received radiotherapy in the past 5 years was higher than in 2003-2009 (53% vs. 30%, P = 0.09). Conclusions In modern urological practice, more exposure to RT and previous surgeries for incontinence are associated with increased risk for revision with decline in AUS survival. [ABSTRACT FROM AUTHOR]