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Introduction: Prostate cancer is being diagnosed and graded by examining needle biopsies. As needle biopsies may represent the low percentage of general tumor histology, downgrading or upgrading can cause problems in radical prostatectomy (RP) specimens. Our aim in this study was to put forth the concordance between needle biopsy and RP Gleason scores. Methods: The biopsy pathology results, and post-RP pathology results of 112 patients diagnosed as prostate cancer and underwent RP were revised and the concordance of the biopsy and RP Gleason score was analyzed by kappa statistics in addition to percentages of downgrading or upgrading rates. Results: The mean age, and PSA values of the patients were 64,4 (±6,2) years, and 11,7 (±9,2) ng/mL, respectively. There was a moderate agreement between biopsy and prostatectomy gleason scores(κ=0,452) and between Gleason groups Conclusion: It is important for the urologists to be aware of the variety of Gleason score between biopsy results and prostatectomy specimens as needle biopsies represent small areas of tumors

Background: Evidence-practice gaps exist in urology. We previously surveyed European Association of Urology (EAU) guidelines for strong recommendations underpinned by high-certainty evidence that impact patient experience for which practice variations were suspected. The recommendation “Do not offer neoadjuvant androgen deprivation therapy (ADT) before surgery for patients with prostate cancer” was prioritised for further investigation. ADT before surgery is neither clinically effective nor cost effective and has serious side effects. The first step in improving implementation problems is to understand their extent. A clear picture of practice regarding ADT before surgery across Europe is not available. Objective: To assess current ADT use before prostate cancer surgery in Europe. Design, setting, and participants: This was an observational cross-sectional study. We retrospectively audited recent ADT practices in a multicentre international setting. We used nonprobability purposive sampling, aiming for breadth in terms of low- versus high-volume, academic, versus community and public versus private centres. Outcome measurements and statistical analysis: Our primary outcome was adherence to the ADT recommendation. Descriptive statistics and a multilevel model were used to investigate differences between countries across different factors (volume, centre type, and funding type). Subgroup analyses were performed for patients with low, intermediate, and high risk, and for those with locally advanced prostate cancer. We also collected reasons for nonadherence. Results and limitations: We included 6598 patients with prostate cancer from 187 hospitals in 31 countries from January 1, 2017 to May 1, 2020. Overall, nonadherence was 2%, (range 0–32%). Most of the variability was found in the high-risk subgroup, for which nonadherence was 4% (range 0–43%). Reasons for nonadherence included attempts to improve oncological outcomes or preoperative tumour parameters; attempts to control the cancer because of long waiting lists; and patient preference (changing one's mind from radiotherapy to surgery after neoadjuvant ADT had commenced or feeling that the side effects were intolerable). Although we purposively sampled for variety within countries (public/private, academic/community, high/low-volume), a selection bias toward centres with awareness of guidelines is possible, so adherence rates may be overestimated. Conclusions: EAU guidelines recommend against ADT use before prostate cancer surgery, yet some guideline-discordant ADT use remains at the cost of patient experience and an additional payer and provider burden. Strategies towards discontinuation of inappropriate preoperative ADT use should be pursued. Patient summary: Androgen deprivation therapy (ADT) is sometimes used in men with prostate cancer who will not benefit from it. ADT causes side effects such as weight gain and emotional changes and increases the risk of cardiovascular disease, diabetes, and osteoporosis. Guidelines strongly recommend that men opting for surgery should not receive ADT, but it is unclear how well the guidance is followed. We asked urologists across Europe how patients in their institutions were treated over the past few years. Most do not use ADT before surgery, but this still happens in some places. More research is needed to help doctors to stop using ADT in patients who will not benefit from it.

This study aims to investigate whether the calcification of renal arteries and aorta may be risk factors for developing chronic kidney disease (CKD) after Nephron sparing surgery (NSS).The patients that underwent either open or laparoscopic NSS from 2000 to 2019 in 4 different centers were retrospectively assessed. Of these patients, 328 had a non-contrast-enhanced computer tomography. Calcium scores of the renal arteries and abdominal aorta were measured in the non-contrast-enhanced images with the calcium score plugin (version 2.0) of Horos™. Univariate and multivariate logistic regression analysis was performed to determine significant risk factors for developing CKD at the last check-up. Roc curve analysis was performed to determine the optimal cut-off values of age and abdominal aorta calcium scores.A total of 302 patients, of which 52 (16,6%) with CKD and 252 (83,4%) without CKD at the last check-up, were included in the analysis. The mean warm ischemia duration was significantly higher in patients with CKD (18,79±6,72 vs 16,38±5,57 minutes, p=0,016). The mean size of the tumor diameter and the number of the patients with ≥stage T1b were higher in the group with CKD (p=0,024 and 0,005, respectively). The median calcium scores of the aorta and renal arteries were higher in the group with CKD (p0,001 and p0,001, respectively). In multivariate analysis, age60 years (OR:3,65, p=0,022), calcium score of the aorta (OR:4,07, p=0,029), tumor diameter (OR:1,03, p=0,026) and pre-operative CKD stage (OR:10,13, p0,001) found the be significant factors for predicting last check-up CKD.The calcium score of the aorta may be used as an additional risk factor to predict post-operative CKD risk after NSS with sensitivity over 80%.

Ulaşım ve iletişim araçlarının gelişmesiyle insanlar vakitlerini hem köylerinde hem de kentte geçirme imkânı bulmuştur. Birçok bölgede, insanlar köyün ve kentin sosyo-ekonomik avantajlarını birleştirerek refah seviyelerini artırma çabasındadır. Araştırmanın amacı, köy ve kentin fırsatlarını birlikte değerlendirenlerin refah seviyelerinde olumlu gelişmeleri ortaya koymaktır. Bu çalışmada etnografik yöntemin katılımcı gözlem ve mülakat teknikleri kullanılmıştır. Araştırmada köyden kente göç etmiş ancak köyle bağlarını koparmamış aileler incelenmiştir. Araştırmanın evrenini Erzurum’un Oltu ilçesinin Sivridere mevkiinde bulunan köyler oluşturmaktadır. Bu aileler on yıl gözlemlenmiş ve gerekli görüldüğünde aile bireyleriyle görüşmeler yapılmıştır. Araştırma bulgularına göre, ailelerin kentin fırsatlarından olan gelir ve servetin değerlendirmesi, istihdam, daha yaşanabilir konut, sağlık ve eğitim, kamu kurumlarına yakınlık imkânlardan yararlandığı ortaya çıkmaktadır. Diğer yandan köylerin avantajlarından yararlanama biçimi ise; boş zamanların değerlendirilmesi, alışılan akrabalık ve arkadaşlık ilişkileri, doğal, güvenli ve sakin yaşam gibi imkânlardır. Bu yeni yaşam biçimi ailelere köy ile kentin avantajlarını aynı anda yaşama imkânı vermesi açısından önemlidir., With the development of transportation and communication tools, people found the opportunity to spend their time both in their villages and in the city. In many regions, people strive to increase their welfare by combining the socio-economic advantages of the village and the city. The aim of the research is to reveal positive developments in the welfare levels of those who evaluate the opportunities of the village and the city together. In this study, participant observation and interview techniques of the ethnographic method were used. In the study, families who migrated from the village to the city but did not break their ties with the village were examined. The population of the research consists of the villages located in the Sivridere area of the Oltu district of Erzurum. These families were observed for ten years and interviews were conducted with family members when deemed necessary. According to the research findings, it is revealed that families benefit from the opportunities of the city, such as the evaluation of income and wealth, employment, more livable housing, health and education, and proximity to public institutions. On the other hand, the way of benefiting from the advantages of the villages; leisure time, usual kinship and friendship relations, natural, safe and quiet life. This new way of life is important in terms of giving families the opportunity to experience the advantages of the village and the city at the same time.

Kentleşmenin artması ile özellikle çok katlı binalarda ortak işlerin yapılması için konut kapıcıların çalıştırılması yaygınlaşmıştır. Bu meslek zamanla kentlerin bütününe yayılmıştır. Konut kapıcılarının sayısındaki artış beraberinde hukuki düzenlemeleri de getirmiştir. Araştırmanın amacı, Ağrı ili Merkez ilçesinde, konut kapıcısı olarak çalışanların görev ve haklarını süreç içerisinde ele almak ve karşılaştıkları sorunları tespit etmektir. Araştırmanın verileri katılımcı gözlem yöntemi kullanılarak toplanmıştır. Araştırma sırasında gözlemlenen dokuz konut kapıcısı, iki apartman yöneticisi ve üç atık kömür toplayıcısı bulunmaktadır. Araştırma sonucunda, konut kapıcıları iş bulurken akraba ve hemşerilerinden yardım aldıkları, sözlü sözleşme ile işe başladıkları, işten ayrılırken fesih süreleri ve tazminatları dikkate alınmadığı görülmüştür. Konut kapıcılarının aldığı ücret asgari ücret seviyesindedir. Çalışma saatleri bazı dönemlerde çok yoğunlaşsa da yılın tümü göz önüne alındığında haftalık kırk beş saatin altında kaldığı söylenebilir. Konut kapıcılarının çoğu kapıcı konutundan yararlanamamaktadır. Kayıtsız çalıştıklarından dolayı primli sosyal güvenlik kollarından faydalanamamaktadırlar. Diğer taraftan konut kapıcıları atık kömür toplayıcılarını çalıştırarak, ev kiralayanlardan komisyon alarak ve kurye işleri yaparak ek menfaat elde ettikleri görülmüştür.

IntroductionMucinous adenocarcinomas of the testicular surface epithelial tumors are very rare and are similar to malignant ovarian-type surface epithelial tumors. Although only 32 cases have been reported to date, there are only five cases of primary testicular mucinous carcinoma with access to literature in English. So there is still limited information about clinical, etiopathogenesis and treatment options.Case reportIn this article, we discuss a 56-year-old male patient diagnosed with testicular mucinous adenocarcinoma due to its rarity in the light of literature review. Management and outcome: We preferred cisplatin-paclitaxel regimen for adjuvant treatment. We then used sequential treatments including oxaliplatin, 5-fluorourasil, etoposide, gemcitabine, and docetaxel to treat metastatic disease. The patient underwent lung metastasectomy for the first relapse. The patient was diagnosed in November 2013 and the response to treatment was evaluated in December 2019 and stable disease was detected. The patient, who has a total survival of 73 months, is still under treatment.DiscussionExcluding malign transformation and borderline mucinous testicular tumors from mucinous cystadenomas of the testis, the knowledge on carcinogenesis, clinical course, and treatment of primary testicular mucinous adenocarcinomas is very limited.

Geleneksel köy yaşamında ekmek kadar önemsenen başka bir besin kaynağı yoktur. En fazla tüketilen ve bu kadar çok önemsenen ekmeğin, üretim süreci de uzun ve oldukça meşakkatlidir. Köy yaşamında ekmeğin üretimi kadın ve erkeğin iş bölümü ve iş birliğine dayanır. Bu çalışmanın amacı, geleneksel köy çalışma hayatında ekmeğin üretim sürecini ve ortaya konulan topyekûn emeği toplumsal cinsiyete dayalı işbölümü ve işbirliği çerçevesinde irdelemektir. Araştırmanın evrenini Erzurum’a bağlı Oltu ilçesinin Sivridere mevkiinde bulunan köyler oluşturmaktadır. Araştırmada etnografyanın veri toplama tekniklerinden katılımcı gözlem ve derinlemesine mülakat teknikleri kullanılmıştır. Yaklaşık altı yıllık süreçte, yerleşim yerleri, çalışma biçimleri, kadın-erkek işbölümleri ve işbirlikleri gözlemlenmiş ve geleneksel döneme ait bilgiler toplanmıştır. Aynı zamanda bölge insanlarıyla mülakatlar yapılmıştır. Araştırma sonucunda, buğdayın ekimden sofraya gelişine kadar bazı işlerde erkeğin bazı işlerde ise kadının ağır bastığı ortaya çıkmıştır. Ortaya çıkan bulgular bugüne ait olanı değil kabaca Cumhuriyet sonrasından 1970’lere kadar olan geleneksel köy iş hayatını anlatmaktadır.Tarlanın ekime hazır hale getirilmesinde, tohum ekiminde, tarlanın sulanmasında, sapların tarlada toplanmasında, harmana getirilmesinde, harman yapılmasında ve değirmende buğdayın öğütülmesinde erkeklerin çalıştığı tespit edilmiştir. Ekinlerin biçilmesinde, toplanmasında, buğdayın yıkanmasında, kurutulmasında, hamur yapımında ve ekmeğin pişirilmesinde ise kadınların çalıştıkları gözlemlenmiştir., There is no other food source that is as important as bread in traditional village life. The production process of bread, which is consumed the most and given so much importance, is also long and very arduous. The production of bread in village life is based on the division of labor and cooperation between men and women. The aim of this study is to examine the production process of bread and the total labor in traditional village working life within the framework of gender-based division of labor and cooperation. The population of the research consists of villages located in Sivridere district of Oltu district of Erzurum. Participant observation and in-depth interview techniques, which are among the data collection techniques of ethnography, were used in the research. In a period of about six years, settlements, working styles, division of labor and cooperation between men and women were observed and information on the traditional period was collected. At the same time, interviews were conducted with the people of the region. As a result of the research, it has been revealed that men dominate in some jobs and women dominate in some jobs from planting to table. The findings that emerged do not describe the present day, but roughly describe the traditional village business life from the post-Republican era to the 1970s.It has been determined that men work in making the field ready for planting, planting seeds, irrigating the field, collecting the straw in the field, bringing it to the threshing, threshing and grinding the wheat in the mill. It has been observed that women work in harvesting and harvesting the crops, washing and drying the wheat, making dough and baking the bread.

WOS: 000470931300007 PubMed ID: 30873655 Objective To analyze factors influencing reflux resolution in patients with the coexistence of non-neurogenic lower urinary tract dysfunction and vesicoureteral reflux. Methods The data of 153 children who were diagnosed with vesicoureteral reflux and accompanying non-neurogenic lower urinary tract dysfunction between 2010 and 2015 were retrospectively evaluated. Patients with neurogenic and anatomical malformations, monosymptomatic nocturnal enuresis, previous history of vesicoureteral reflux surgery, irregular and/or incomplete follow-up data were excluded. After exclusion of 55 patients, 98 patients were enrolled in this study. Patients were divided into two groups according to the presence of spontaneous vesicoureteral reflux resolution during the follow-up period. Group 1 consisted of 54 children with spontaneous vesicoureteral reflux resolution, whereas group 2 included 44 children without resolution. Medical history, physical examination, urinalysis, uroflowmetry combined with electromyography, ultrasonography, as well as the Dysfunctional Voiding and Incontinence Symptom Score questionnaire were also evaluated. Results The mean age at presentation was 7.57 +/- 0.23 years (range 5-13 years), and the mean follow-up period was 28.3 months. Significant differences were noted between the two groups in terms of dysfunctional voiding and incontinence symptom score, bladder wall thickness, and the post-void residual urine volumes. In addition, lower urinary tract symptoms, namely frequency, urgency and daytime incontinence, were found to be higher in group 2. In multivariate analysis, post-void residual urine volume and Dysfunctional Voiding and Incontinence Symptom Score were found to affect reflux resolution rates (P = 0.002, P = 0.002, respectively). Conclusions The absence of significant post-void residual urine volume, and a low Dysfunctional Voiding and Incontinence Symptom Score increase the likelihood of spontaneous resolution rates of vesicoureteral reflux in children with non-neurogenic lower urinary tract dysfunction.

We present a unique case with a ureteral fibroepithelial tumor originating from the ureter, which could be confused with a bladder tumor on ultrasound examination due to its movement in and out of the bladder. METHODS: In cystoscopy, a papillary tumor lesion emerging from the right ureteral orifice was seen. After scanning the other quadrants, however, the tumor was not observed at the right ureteral orifice. It was then protruded back into the bladder. The tumor was seen several times to protrude into the bladder and return to the ureter, possibly due to ureteral peristalsis. Then, a semi-rigid ureteroscope was introduced through the right ureteric orifice, and the tumor was excised in one piece using Holmium laser fiber with 365μm of diameter. The size of the removed tumor was approximately 8 cm long. A double-j stent of 4.8 Fr was placed in the ureter. RESULTS: The patient was discharged on the first day without complications. The fibroepithelial polyps of the ureter, which consist of the stroma of mesoderm origin, covered with histologically normal or hyperplastic urothelial epithelial cells, are extremely rare tumors. It is important to distinguish these polyps from urothelial cancers, since these two entities are different in treatment and prognosis, although similar in symptoms and imaging procedures. CONCLUSIONS: Minimally invasive treatment techniques can be safely applied in the treatment of such exceedingly rare tumors. Presentamos un caso único de tumor fibroepitelial ureteral originado en el uréter que se puede confundir con un tumor vesical por ecografía debido al movimiento dentro y fuera de la vejiga. MÉTODOS: En la cistoscopia, se vió una lesión tumoral papilar saliendo del meato ureteral. Después de mirar el resto de zona de la vejiga, dejamos de ver el tumor en el meato ureteral derecho. Una vez más, protuía después, en la vejiga. Se realizó una ureteroscopia semirrígida y se quitó el tumor en una pieza con laser holmium de 365. El tumor tenía una longitud de 8 cm. Se colocó un catéter doble J 4.8 Fr en el uréter. RESULTADOS: El paciente fue dado de alta en el primer día postoperatorio sin complicaciones. El pólipo fibroepitelial del uréter consiste en estroma del mesodermo cubierto de histológica normal o hiperplásica. Estos tumores son extremadamente raros. Es importante diferenciarlos de los tumores uroteliales ya que el tratamiento y pronóstico es diferente, aunque los síntomas y las técnicas de imagen son parecidas. Las técnicas mínimamente invasivas se pueden aplicar a estos tumores tan poco comunes.

Introduction Endothelial glycocalyx is a luminal layer which can be damaged by inflammatory agents or pathogens. The endothelial glycocalyx damage is thought to have a role in the formation of renal scars in children who have febrile urinary tract infection and vesicoureteral reflux. This study aimed to compare the blood levels of endothelial glycocalyx components heparan sulfate and Syndecan-1 in children with and without renal scarring due to vesicoureteral reflux-associated febrile urinary tract infection. Materials and methods Data of the patients diagnosed with vesicoureteral reflux without renal scarring (Group 1), patients with vesicoureteral reflux and renal scarring (Group 2), and completely healthy children (Group 3) were retrospectively reviewed. Blood levels of heparan sulfate and Syndecan-1 were measured and the results were compared. Results The entire cohort consisted of 90 patients; there were 30 patients in each group. Mean patient age was 49.7 ± 18.0 months. Mean serum heparan sulfate (42.90 ± 18.90 ng/mL) and Syndecan-1 (37.59 ± 13.77 ng/mL) levels of Group 2 were significantly higher than those of other groups. The cut-off value for heparan sulfate was 35.17 ng/mL, with a 63% sensitivity and 86% specificity. The cut-off value for Syndecan-1 was 29.99 ng/mL with a 70% sensitivity and 80% specificity. Conclusion Our findings indicate that blood levels of heparan sulfate and Syndecan-1 could be related with renal scarring in patients with vesicoureteral reflux, especially in the setting of febrile urinary tract infection. However, due to their low sensitivity, these biomarkers should be used along with clinical data.

Objective: Up to 80% of prostate cancer cases are indolentthat pose a minimal risk for morbidity and mortality throughoutthe life of the patient. Cancer-specific survival of the patients justfollowed up and those who received curative treatment were found tobe similar, especially in the low-risk category. Active surveillance wasdescribed to preserve the quality of life of the patients and to protectthem from the side effects of curative treatments. It has become increasinglyused in low and very low risk. Although there are manystudies on this subject with a large number of patients in the literature,we aimed to present our first results in this study. Material andMethods: The data of the patients, that were included in the activesurveillance program between January 2012 and April 2020, were retrospectivelyanalyzed. The patients were diagnosed with low-riskprostate cancer according to D’Amico criteria (International Societyof Urological Pathology grade group 1, prostate-specific antigen

Introduction: This study aimed to analyze the efficacy and safety of the percutaneous nephrolithotomy procedure in octogenarians and compare them with the outcomes in a young patient group. Materials and Methods: Patients older than 80 and younger than 90 were included in Group 1, and patients younger than 65 were assigned to Group 2. Group 1 included 45 patients, and Group 2 consisted of 90 patients recruited by one-to-two case-control matching based on gender, stone area, and the number of staghorn stones. Results: The mean patient age was 81.89 +/- 1.70 and 38.7 +/- 12.5 years in Groups 1 and 2, respectively. The patients in Group 1 had a significantly higher rate of systemic hypertension. Pre-operative and post-operative serum creatinine levels were higher in Group 1 than in Group 2. The groups did not differ in terms of the preoperative serum hemoglobin level. However, the postoperative serum hemoglobin level was significantly lower in Group 1. There was no difference between the two groups in terms of the rate of blood transfusions. The duration of hospital stay was significantly longer in Group 1. However, the two groups were not different in terms of minor and major complications. The stone-free rates were calculated as 73.3% and 77.8% in Groups 1 and 2, respectively. There was no difference between the groups in terms of stone-free rates (p = 0.567). Conclusion: The percutaneous nephrolithotomy procedure is an effective and safe method for treating renal stone disease in octogenarians.

OBJECTIVE To evaluate the perspectives of radiation oncologists (ROs), medical oncologists (MOs) and urologists (UROs) towards active surveillance (AS) in the management of prostate cancer (PCa). METHODS A questionnaire with total of 24 questions was sent out via e-mail to the physicians. 244 participants completed the questionnaire. Pearson Chi square test and multivariable logistic regression models were used to identify physicians’ characteristics and attitudes about AS. RESULTS There were 129 UROs (52.9%), 76 ROs (31.1%) and 39 MOs (16%) in the study population. The analysis of the important factors while considering AS showed that prostate cancer risk group (85.7%) was the most commonly considered criteria, followed by patient’s request and compliance (84.8%), life expectancy (76.2%) and sexual activity of the patient (34.8%). The AS was recommended by 86.8% of UROs, 77.6% of ROs and 61.6% of MOs (p=0.002). In multivariate analysis, practicing as ROs (p=0.031) or UROs (p

This study aimed to determine oxidative stress in the tissue after testicular torsion biochemically and histopathologically and to examine the effects of Nesfatin-1 treatment on this injury. Thirty-two rats were randomly divided into four groups: sham, torsion + detorsion (4 hr torsion followed by 1 hr detorsion), ischaemia/reperfusion + saline (I/R + S) and I/R + nesfatin-1. I/R + S group a single-dose saline treatment was administered intraperitoneally at the two-hundred-tenth minute of torsion (ischaemia; 10 cc/kg). Similarly, I/R + nesfatin-1 group a single dose of nesfatin-1 treatment was administered intraperitoneally at the two-hundred-tenth minute of ischaemia (10 µg/kg). Myeloperoxidase, total oxidant status and oxidative stress index values were significantly increased in the I/R and I/R + S group compared to the sham group. Superoxide dismutase was significantly decreased in the I/R + S group compared to the sham group. No significant difference was found between the I/R + nesfatin-1 group and the other I/R groups (I/R and I/R + S) in terms of biochemical parameters. The mean diameter of the seminiferous tubule decreased in the I/R groups. However, the mean diameter of the seminiferous tubules was not significantly different between the I/R + S group and the I/R + nesfatin-1 group. Thus, the administration of nesfatin-1 after ischaemia did not reduce testicular-oxidative stress.

0000-0003-0238-2236; 0000-0003-1398-1592; 0000-0002-0973-2318 WOS: 000444033700006 Objective: The aim of the study was to investigate gender-specific differences in the Turkish patients with renal cell carcinoma (RCC) undergoing radical or nephron-sparing nephrectomy and compare the results with those in other regions. Materials and Methods: Data of 76 patients, who were clinically diagnosed with RCC and underwent radical or nephron-sparing nephrectomy from January 2011 to August 2017, were retrospectively evaluated. Age and gender of the patients and the size, histological type, grade and pathological stage of the tumors were recorded. A chi-square test was used for comparing categorical variables, whereas the Student's t-test was used for the same purpose in the continuous variables. Results: Of the 67 patients, 39 (58.2%) were male and 28 (41.8%) were female; male-to-female ratio was 3:2. The mean age of the male and female patients was 63.4 +/- 11.7 years and 59.3 +/- 14.3 years, respectively and the mean tumor size was 5.7 and 5.3 cm, respectively. There were differences in mean age, tumor size and Fuhrman grade, however, none of them reached the level of statistical significance. Twenty four of the male and 25 of the female patients had low-stage, 15 of the male and 3 of the female patients had high-stage disease. Thus, the male patients had higher stage disease than the female patients and the difference was statistically significant (p=0.011). Conclusion: Turkish women with RCC had significantly lower stage disease than Turkish men, although grade and size of the tumor did not present a statistically significant difference. The results were similar with other European studies.

Currently the accepted screening tools for prostate cancer are prostate specific antigen (PSA) and rectal examination. PSA is specific to prostate, but not to prostate cancer. Therefore, identifying prostate cancer only by serum PSA measurement has low specificity and may lead to false positive results and unnecessary biopsies. Due to these problems, it is investigated to increase the effectiveness of PSA and/or to find new biomarkers. However, it does not seem possible to have the adequate benefit from only one biomarker due to heterogeneous feature of prostate cancer. Therefore, in the recent years, combined use of biomarkers became a current issue and higher sensitivity and specificity rates were established.

0000-0003-0238-2236 WOS: 000451975400017 Splenogonadal fusion, which can be clinically confused with testicular neoplasms as they present with testicular swelling, is a rare abnormality in young adults. Intraoperative frozen section analysis can be helpful in diagnosing such cases and preventing unnecessary orchiectomies. We report a case in which frozen section analysis was done and testis-sparing surgery could be performed.

Urothelial bladder carcinoma is a rare condition in young patients. Clinicians have less inclination to perform cystoscopy in this age group because benign causes of hematuria are more common. Thus, diagnostic delays of up to one year may occur. We report a 24-year-old male patient with urothelial bladder cancer. Clinical behavior and prognosis in young individuals are controversial. The definitions of “young patient” are highly variable and different World Health Organization pathological classification systems are used for reporting. Generally, it presents as a low-stage and low-grade disease, nevertheless, it may present with high-grade tumors, even with muscle-invasive cancer.

Hayvancılıklauğraşıp aynı zamanda bölgenin çoban ihtiyacını büyük ölçüde gideren Erzurum İliŞenkaya İlçesi Atyolu Köyü’nün çoban çalışanları araştırmanın konusudur. Mevsimsel olarak göç edip çoban olarakçalışan bu köylülerin çalışma hayatı ile ilgili veriler elde edilmeyeçalışılmıştır. Araştırmada katılımcı gözlem yöntemi kullanılarak veriler eldeedilmiştir. İş hukuku açısından önem arz eden çalışma saatleri, izinler, çalışanlarınişverene karşı sorumlulukları ve hakları ele alınmaktadır. Diğer yandan temelyaşam gereksinimleri açısından önem arz eden beslenme, giyinme ve barınmalarınayönelik te araştırma yapılmıştır. Araştırmanın sonuçlarına göre iş kanununauygun olmayan çalışma saatleri, izinler, kayıt dışı çalışılması, sosyalgüvenlik kaydının bulunmaması en önemli sorunlarını teşkil etmektedir. Aynızamanda, temel yaşam gereksinimlerinde de birçok eksiklikler olduğu tespitedilmiştir.&nbsp, The topic of the research is animal husbandry invillage of Atyolu in the district of Senkaya Erzurum regarding connection withthe need of shepherds working in the region. The working life conditions ofvillagers who are seasonal immigrants have been observed. In the study data wascollected through observation methods. Working hours, compensatory leave,responsibilities and rights of employers which are very important in labor lawwere all considered in the study. Furthermore the research was carried out onnutrition, clothing and shelter all of which are significant in terms of basiclife necessities. According to the results of the survey, long hours, irregularcompensatory leaves, unregistered employment, and lack of social securityconstitute the most important problems for the shepherd. Moreover, it has beendetermined that there are many deficiencies in basic life requirements.

Introduction The aim of this study was to determine the minimal core length to be taken per cc of prostate volume for an effective prostate biopsy. Patients and Methods A retrospective analysis was performed on the records of 379 patients who underwent a first prostate biopsy with 12 to 16 cores under transrectal ultrasound guidance between September 2012 and April 2015. For each patient, the core length per cc of the prostate and the percentage of sampled prostate volume were calculated, and these values were compared between the patients with and without prostate cancer. Results A total of 348 patients were included in the study. Cancer was determined in 26.4% of patients. The mean core length taken per cc of prostate and the percentage of sampled prostate volume were determined to be 3.40 ± 0.15 mm/cc (0.26%; range, 0.08-0.63 cc) in patients with cancer and 2.75 ± 0.08 mm/cc (0.20%; range, 0.04-0.66 cc) in patients without cancer (P = .000 and P = .000), respectively. Core length taken per cc of prostate of > 3.31 mm/cc was found to be related to an increase in the rates of prostate cancer diagnosis (odds ratio, 2.84; 95% confidence interval, 1.68-4.78). The rate of cancer determination for core length taken per cc of prostate of 3.31 mm/cc, 41.1%. Conclusions Core length taken per cc of prostate and the percentage of sampled prostate volume are important morphometric parameters in the determination of prostate cancer. The results of study suggest a core length per cc of the prostate of > 3.31 mm/cc as a cutoff value for quality assurance.

Kırdan kente göç türünü inceleyen bu çalışma uzun dönemli gözleme dayanarak hazırlanmıştır. Araştırmada, köyde ikamet ettiği sürece evlenemeyen genç erkekler ve evliliği kente göç etmede fırsata çeviren genç kızlar ele alınmış ve her iki kesimin göç nedenleri ile göç sonrası sorunları irdelenmiştir. Kırdan kente göç edenlerin göç nedenleri arasında kentli olma, yoğun çalışma hayatından kurtulma, geleneksel aile yapısındaki kayın, görüm, elti, kaynana ve kaynatadan ayrı yaşayıp çekirdek aile kurma istekleri bulunmaktadır. Köyde kaldığı sürede evlenemeyen genç erkeklerin, kente göç edip iş bulunduklarında evlendikleri tespit edilmiştir. Köyde yaşamına devam eden yaşlılar ise, bir dönem geleneksel yapının zorluklarını (gelinlik, yaşam koşullarındaki zorluklar vb.) yaşamış olmanın yanı sıra bugün de modern dönemin sorunlarından olan yalnızlığı yaşamaktadırlar. Göçmen erkeklerin kentte karşılaştıkları sorunlar oldukça fazladır. Bunlardan başlıcaları; İş bulmak, işe uyum sağlamak, çalışma yaşamında esnekliğin az olması, kent hayatına uyum sağlamak, barınma ve beslenme giderleridir. Göçmen kadınların ise komşuluk ilişkilerinin sınırlı olması, çalışma yaşamına katılamaması, kent hayatına uyum sağlayamaması gibi sorunları bulunmaktadır. Köyde geleneksel yapıda, ürettiğini tüketme ve günlük farklı işlerin yapma alışkanlığı modern sistemde yerini üretmediğini tüketmeye ve tek tip iş yapmaya bırakmıştır. Bu durum göç edenleri olumsuz yönde etkilemektedir.&nbsp, The study of the trend of urban – rural population shift is based on long-term observation. In the studies, cases of young men who could not marry as long as they lived in a village, and young women who transformed marriage into an opportunity to migrate to urban areas were addressed, showing both reasons for migration and the problems of an after migration life. The reasons for migration following are a wish to dismiss intense working life and the hope of creating a nuclear family, avoiding a traditional relationship with one’s in-laws. It was determined that young men were not able to marry while living in the village and they could find job and marry very soon after moving to city. Elders who continue their lives in the village who also once experienced the difficulties of traditional structure (finding a bride, difficulties in living conditions etc.) also live in loneliness, which is a significant issue of our time. The traditional village structure of consuming what they produce and doing various types of work is replaced by readymade product consumption and monotonous work. This has negative effects on migrants. Migrant men face a lot of problems, in cities such as finding a job, adapting to work, a lack of flexibility in working life, adapting to urban life, and finding accommodation and adequate nutrition. Migrant women have difficulties with limited neighborhood relations, an inability to participate working life, and a failure to adapt to urban life.&nbsp

WOS: 000435448100012 Renal angiomyolipoma (R-AML) is one of the most common benign neoplasms of the kidney. It is usually asymptomatic and rarely becomes symptomatic. Management of R-AML is still controversial. Generally, follow-up is enough for the management of the disease but rarely, life-threatening complications may develop. Here, we would like to present a case of huge R-AML with life-threatening bleeding with literature review.

Objectives This study aimed to evaluate the effects of intravesical instillation of the anticholinergic drugs oxybutynin, tolterodine, and trospium on bladder capacity and histopathological changes in the bladder mucosa. Methods The study included 20 male New Zealand white rabbits that were randomly allocated to four groups of five. In the oxybutynin, tolterodine, and trospium groups, the drugs used were 1 mg/kg of crushed tablet mixed with 5 mL of saline, instilled intravesically once per day for 4 weeks. The control group was administered only 5 mL of saline once per day for 4 weeks. Urodynamic measurement of the bladder was made before and after treatment. At the end of the treatment the animals were killed and the bladders were evaluated histopathologically. Results There were no significant differences between pre- and post-treatment bladder capacity in any of the groups (P > 0.05). Histopathological evaluation showed that the mucosal epithelium was intact and there was minor inflammation in the control group and oxybutynin group (P > 0.05), whereas there was destruction of the mucosal epithelium and findings of diffuse inflammation in the tolterodine (P = 0.014) and trospium (P = 0.014) groups. Conclusion Intravesical oxybutynin treatment was observed to be safe; however, a single daily dose of oxybutynin may not be sufficient to increase bladder capacity. Intravesical use of trospium and tolterodine at high doses caused epithelial destruction and diffuse inflammation in the bladder mucosa. The irritation associated with epithelial destruction and inflammation prevented an increase in bladder capacity.

WOS: 000218505900003 Objective To compare changes in collagen type 3, elastin, fibrosis and cajal cells through histopathological examination of the ureteropelvic junction (UPJ) segments of pediatric and adult patients who had undergone AndersonHynes pyeloplasty for ureteropelvic junction obstruction (UPJO). Materials and Methods Histopathological evaluation was made of the UPJ segments of 52 patients who underwent Anderson-Hynes pyeloplasty for UPJO between January 2005 and January 2008. Patients were separated into 2 groups as pediatric, aged 15 years (group 2, n=42). UPJ segments of both groups were compared histopathologically (collagen type 3, elastin, fibrosis and cajal cells). Radiographic evaluations were made with diuretic renogram and/or intravenous pyelography. Results Mean age of group 1 patients was 8.12 +/- 2.6 years (1-12 years) and of group 2 patients, 38.16 +/- 5.91 years (16-62 years). Mean follow-up period was 18 months (9-24 months). No statistically significant difference was determined between the groups in respect of collagen type 3, elastin, fibrosis or cajal cells (p>0.05). Conclusion As the pathology in the UPJ obstruction is a congenital defect, the histopathology does not change with age.

Background: PSA levels between 0-4 ng/ml is generally accepted as normal range, there is no world widely accepted cut-off value. PSA level is most commonly used for determining patients to whom needle biopsy should be performed. Authors aimed to investigate the relationship between preoperative PSA level and histopathological features.Methods: Ninety prostatic adenocarcinoma cases diagnosed between January 2013 and January 2018 and treated by RP were included. Patients had no measurement of PSA before the operation were excluded from the study. Patients were grouped according to preoperative PSA as low-risk (20 ng/ml). The relations between all of the histopathological parameters were analyzed in addition to the preoperative PSA levels.Results: The mean age and preoperative PSA level was found as 64.16, and 12.33, respectively. The presence of EPE and tumour positive base margin showed significant relation among PSA groups as well as the presence of lymphovascular invasion and the involvement of the seminal vesicles. Intracytoplasmic mucin and foamy cytoplasm was more common in low-risk PSA group and the difference was significant.Conclusions: PSA level is one of the most commonly used marker for predicting high risk patients before the operation however it may also show relation with various histopathological factors that have effect on the prognosis of prostatic adenocarcinoma.

Objectives: To investigate the efficacy of single or double epirubicin instillation during the early postoperative period (EPP) in intermediate-risk non-muscle-invasive urothelial cancer. Methods: Patients with primary and solitary or multiple (3 or less) Ta (grade 2–3) or T1 (grade 1–2) tumors were enrolled. Patients were randomized to receive either a single dose of 100 mg epirubicin instillation within 6 h or a second 100 mg epirubicin instillation during the 12th–18th hours after a complete TUR-BT. At the end of the 60-month follow-up period, the available data were statistically analyzed. The end-points of the study were determined as disease-free survival, progression and recurrence rates, time to recurrence, and time to progression. Results: A total of 299 patients from 24 institutions were randomized between January 2002 and June 2004. There were 143 patients from 18 institutions who met the eligibility criteria. The follow-up and disease-free survival periods were 16.9 months and 16 months, respectively. There was no statistical difference in the demographic properties and the end-points between the groups. Conclusions: A single dose of intravesical 100 mg epirubicin chemotherapy during the early postoperative period for primary intermediate-risk non-muscle-invasive urothelial cancer achieved 16 months of mean disease-free survival. A second intravesical epirubicin instillation did not provide any significant benefit.

We compared the efficacy of lornoxicam and tramadol to provide analgesia and comfort during transrectal ultrasound-guided biopsy of the prostate (TRUSP) as a noninvasive method.A total of 62 men undergoing TRUSP were enrolled in this study. Patients were randomized to three groups. Group 1 (n = 21) received 8 mg of lornoxicam, group 2 (n = 21) received 100 mg of tramadol, and group 3 (n = 20) received saline as a control. The drugs were given intramuscularly half an hour prior to the procedure. All patients were asked to indicate the level of pain experienced after the procedure by visual analog score (VAS), and the patient's comfort level was scored by a comfort score. Additionally, the patients were asked if they were willing to undergo a future TRUSP.The data obtained revealed that both experimental groups receiving lornoxicam and tramadol had lower VAS scores compared to the control group (3.4 and 2.4 vs. 6.4, respectively; P0.0001). There were also significant differences in VAS scores between group 1 and group 2 (P = 0.027). There was a significant difference in the comfort score between the drug groups and control (P0.0001) and between the lornoxicam and tramadol group (P0.05). Pain and discomfort were least in the tramadol group. The percentage of patients who would not consent to future TRUSP was lower in the drug groups compared to control (P0.0001). But there were not any differences between the drug groups.The use of lornoxicam or tramadol for pain relief in TRUSP is a practical, effective and comfortable method compared to the results of the control group. In addition, tramadol was found to be more effective than lornoxicam.

We aimed to retrospectively review the efficiency of ureterorenoscopy (URS) applied without ureteral dilatation for evaluating pediatric ureteral pathologies. The files of pediatric patients hospitalized in our clinic between January 2000 and June 2006 due to ureteral stone disease were reviewed and evaluated retrospectively. The ages, medical histories, physical examination results, preoperative routine blood and urinary tests, and culture results were recorded. Ureteral orifice dilatation was not needed in any of the patients. Due to the risk of mucosal trauma and edema development in the ureteral orifice and intramural ureter, 3F and 4F catheters were applied in all patients following the ureterenoscopy. These catheters were removed 24 h after the procedure. The files of 54 pediatric patients with a mean age of 8.5 years (range 1–16 years) were evaluated retrospectively. While diagnostic URS was applied in 12 (22.2%) of the patients, ureteral calculi were determined in 42 (77.8%) patients and the stones were fragmented by pneumatic lithotripter. Twenty-five of the stones were localized in the lower ureter, 16 in the mid-ureter, and 3 in upper ureter. The mean stone size was found to be 7.1 mm (range 4–12). None of the stones migrated to the proximal region. In 2 patients open ureterolithotomy was applied; stones were localized in the upper ureter in both of these patients. Ureterorenoscopy can be successfully and safely applied without the need for ureteral dilatation in ureteral pathologies of children.

Introduction: This study aimed to determine the safety and efficacy of a modified technique for performing transurethral resection of the prostate (TURP) combined with percutaneous cystolithotripsy (PCCL). Methods: Clinical data from 24 patients with benign prostate hyperplasia (BPH) and aggregate stone sizes ≥3 cm were assessed retrospectively between June 2011 and January 2014. All stones fragmented via pneumatic lithotripter were removed. An 18-F Foley catheter was inserted into the Amplatz sheath, which was then removed from the bladder. The Foley catheter balloon was inflated with 15 ml of saline, and suprapubic traction was applied to prevent extravasation. Next, TURP was performed while a suprapubic Foley catheter provided continuous drainage. Results: The mean stone size was 46.25 ± 9.51 mm. The surgical duration for stone removal was 31.25 ± 8.46 min. All patients were stone-free at the first month follow-up. None of the patients experienced extravasation or urethral stricture. Conclusions: PCCL is a short-duration, minimally invasive surgery that avoids urethral stricture. In the presented technique, as the drainage catheter is fixed to the dome of bladder, it is not visualized in the surgical field and remains outside of the resection area, which facilitates prostate resection. It seems to be a safe and efficient technique.

Aim: To investigate the effects of lidocaine gel and parenteral antibiotics and povidine lavage in the treatment of pain occurring during prostate biopsy in terms of infective complications. Patients and methods: Eighty patients with indications for prostate biopsy were randomized into two groups. One group underwent lavage with povidine iodine solution and lidocaine gel, and the other received cephtriaxon and lavage. Pain experienced by the patients was measured by visual analog scale (VAS). Blood samples were taken 15 and 60 min after the procedure, and urine culture antibiograms were taken 60 min after the procedure. Results: The average pain score was 3.70 in Group 1 and 4.25 in Group 2; the difference between the groups was not statistically significant (P>0.05). Likewise, no statistically significant difference between groups was found by the chi square test in either urine or blood cultures (P>0.05). Conclusions Lavage with betadine prior to transrectal prostate biopsy is adequate in the prevention of infective complications; however, because lidocaine gel is not effective against pain, alternative methods for pain management need to be developed.

Ureteral injury is a rare condition. It is difficult to identify the best diagnostic methods and treatment. We report our experience with penetrating ureteral injuries secondary to gunshot wounds. The methods of diagnosis and treatment options of these cases are described and discussed.A retrospective review of ureteral injuries due to penetrating trauma between January 1990 and December 2005, in the Urology and General Surgery departments of our hospital. Ureteral injures were graded according to the AAST-OIS. We evaluated mechanism of injury, initial urinalysis, radiologic and operative procedure, associated injuries, and postoperative complications.A total of twenty-one (sixteen male, five female) cases of gunshot ureteral injuries were evaluated retrospectively. The median patient age was 27.85 years (16-48 years). All patients had signs and symptoms of an acute abdomen and only nine patients were evaluated radiologically. Haematuria was absent in 71.4% of patients (15 of 21). All patients had associated injuries and were evaluated from grade I to V. Grade I had none, grade II had 1 (4.76%), grade III had 3 (14.29%), grade IV had 14 (66.6%), grade V had 3 (14.29%). Ureteral stent or nephrostomy tubes were used in all primarily repaired patients. Two patients developed urinary leakage, which resolved spontaneously.Ureteral injury should always be borne in mind and, when suspected, the surgeon should dissect and visualize the ureter during exploration. Adequate debridment, and ureteral stenting or nephrostomy drainage are good techniques for successful treatment.

This prospective study was performed to determine whether extracorporeal shock-wave lithotripsy (ESWL), widely used for treating renal and ureteral stones, affects the kidney interlobar artery resistive index (RI).A total of 43 patients (30 with renal and 13 with ureteral stones) underwent color Doppler examination before and 30 min and 3 h after ESWL. Seventeen patients with renal and nine with ureteral stones underwent Doppler examination 2 weeks later. Measurements were made near the stones (nearby region), at least 2 cm from the stones (remote region) and in the contralateral kidney for renal stones, and in the ipsilateral and contralateral kidneys for ureteral stones.In patients with renal stones, the RI was increased 30 min and 3 h after ESWL in the nearby and remote regions, and more markedly in the former. In the contralateral kidney, there was an increase in RI only at 3 h, which was less than that in the ipsilateral kidney. The RI at 2 weeks post-ESWL in the nearby region and contralateral kidney did not differ from the pre-ESWL values. ESWL performed for ureteral stones caused no increase in RI in the ipsilateral kidney.Patients with renal stones had a temporary increase in RI in the hours following ESWL in both the ipsilateral and contralateral kidneys, which was highest in the region near the stones and lowest in the contralateral kidney. Two weeks later, the RI in both areas had returned to pre-ESWL levels.

Background: The increasing use of cellulartelephones is known to have harmful effects onhuman health. The aim of this prospective studywas to determine whether cellular telephone useaffected serum PSA levels in men. Methods: Participants included 20 menwith ages ranging from 22 to 65 years who hadnever previously used cellular telephones.Blood samples were taken prior to and 30 daysafter the beginning of cellular telephone use.Serum was separated from the blood samples andstored in a deep freezer until the end of thestudy, at which time serum free and total PSAlevels were determined by tandemradioimmunoassay. The results werestatistically analyzed by the Wilcoxon PairedSigned Rank Test. Results: Average free and total PSAvalues were 2.070 ng/ml and 0.500 ng/ml beforethe study, and 2.0 ng/ml and 0.505 ng/ml at theend of the study, respectively. No significantdifference was determined between the initialand final values (p > 0.05). Conclusions: The results indicatethat cellular telephone use does notsignificantly affect PSA values in the shortterm. Nevertheless, we think that there is aneed for longer-term studies on this subject.

Background: In this study we aimed to discuss whether thegonadal suppression is effective or not in preventing the gonadal toxiceffects of some chemotherapeutics.Methods: Forty Sprague-Dawley adult male rats were randomised into4 groups, each consisting of 10. No drugs were given to the first group. Thesecond group received GnRH agonist and antiandrogen, the third groupreceived COPP chemotherapy protocol and the last group received COPPtogether with GnRH agonist and antiandrogen. Ninety days after drugapplication we sacrificed all rats. Total body weight, testicular weight andtesticular size measurements were all recorded. All testicular tissues wereexamined histologically for the ratio of active seminiferous tubules.Results: There was no difference in total body weight. The weight andmeasurements of testicular tissues were decreased in-group 3 and 4 whencompared with 1 and 2. The amount of active seminiferous tubules wassignificantly less in the third group.Conclusions: As a conclusion we think that gonadal suppressionapplied during chemotherapy regimen could decrease the testicular toxiceffects of chemotherapeutic but more clinical investigations needed forroutine application.

In this study, we aimed to compare the advantages and disadvantages of open varicocelectomy with Kelami's incision versus laparoscopic varicocelectomy in bilateral varicoceles. We performed bilateral varicocelectomy by infrapubic incision in 43 patients with bilateral varicocele in our clinic between November 1995 and June 1997. The results of this method were compared with laparoscopic varicocelectomy results taken from literature. Open surgery has been found more advantageous in relation to the type of anesthesia, duration of the operation, complications and cost-effectiveness. There is no significant difference between the two methods with regard to the time of returning to normal activity. But, postoperative analgesic requirement in open surgery is more than in laparoscopic varicocelectomy. It is not fully known which method is best in varicocele treatment. In our clinic, however, open surgical ligation with Kelami's incision is preferred in bilateral varicocelectomies until a certain concensus is held about this treatment.

Different methods are available in the diagnosis and treatment of urethral strictures. True diagnosis is necessary for choosing the most suitable method of treatment and to inform the patient about the method, complications, recurrence rate and costs. In this study we aimed to compare the efficiency, complications and reproducibility of retrograde urethrography with urethroscopy. The retrograde urethrographic (RGU) and urethroscopic findings of 38 male patients were evaluated. Thirty had the same findings with either technique. In 8 patients the RGU was misdiagnosing (p0.01). In conclusion, it has been shown that the results of RGU are misleading when it is not combined with urethroscopy and we think that it must not be a routine method in the diagnosis of urethral strictures.

Leiomyoma of the bladder is a rare benign mesenchymal tumor. Theclinic symptomatology depends on the tumor site, and this type of lesion ismorefrequently found in women. Treatment mainly consist of endoscopicresection, but may involve partial cystectomy.