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Purpose: To assess the impact of the The Controlling Nutritional Status (CONUT) score, an indicator of nutritional status, on the survival and prognosis after radical cystectomy., Materials and Methods: The medical records of patients who underwent consecutive radical cystectomy operations with the diagnosis of muscle-invasive bladder cancer at our clinic were retrospectively examined. The patients were separated into two groups based on the cut-off CONUT score which was derived using the receiver operating characteristic (ROC) curve. The group with a CONUT score ≥ 3 was categorized as high CONUT, whereas the group with a CONUT score < 3 was categorized as low CONUT. The groups were compaired according to oncological outcomes and survival risk factors., Results: Cancer-specific survival (CSS) and overall survival (OS) were statistically significantly lower in the High CONUT group compared to the Low CONUT group (p<0.001, p=0.024, respectively).  Age (HR: 1.02, 95% CI: 1.006-1.04, p=0.011) and CONUT score (HR: 3.92, 95% CI: 2.66-5.77, p<0.001) were revealed to be independent prognostic variables in the multivariate analysis for OS., Conclusion: The CONUT score was found to be an independent predictor of survival in patients with muscle-invasive bladder cancer in this study.

Introduction: Surgery is one of the treatment alternatives for prostate cancer, and robotic-assisted laparoscopic prostatectomy (RALP) has become the new trend in the past decade. There is no consensus yet for surgeons who will perform RALP whether they need to be trained or experienced in laparoscopy. In this study, it was aimed to investigate the effectiveness of the surgeon's laparoscopy experience in the perioperative and postoperative results of RALP patients., Material and Method: Patients who underwent RALP were retrospectively screened. The first 20 cases done by surgeons in both groups and 40 cases in total were included in the study. Surgeons with laparoscopy training were designated as group 1, and surgeons without laparoscopy training were designated as group 2. Patient's age, preoperative prostate-specific antigen (PSA) value, prostate biopsy pathology, radical prostatectomy pathology, surgical margin positivity, extracapsular extension, and seminal vesicle invasion status, blood transfusion rate, operation time, length of hospital stay, and 1-year follow-up potency and urinary incontinence rates were compared., Results: There was no difference between the two groups in terms of age, preoperative PSA, preoperative biopsy results, blood transfusion rates, operation times, and the length of hospital stay of the patients. When the postoperative oncological and functional results of the patients were examined, there was no difference between the two groups in the prostatectomy pathology ( p  = 0.895), extracapsular extension (pT3a) ( p  = 0.519), positive surgical margin (pSM) ( p  = 0.723), and seminal vesicle invasion (pT3b) ( p  = 0.756). Potency and urinary incontinence rates were similar in both groups at the end of one year follow-up ( p  = 0.327, 0.500 respectively)., Conclusions: Based on our study, it is clearly seen that regardless of the surgeon's experience of laparoscopy, it can be safely preferred when looking at the oncological and functional results of RALP.

Objective: To investigate the effect of the presence of severe hydronephrosis on percutaneous nephrolithotomy (PNL) outcome in patients who underwent PNL operation with one-shot dilatation technique., Materials and Methods: Medical data of 989 patients underwent PNL operation in our clinic between 2012 and 2018 were retrospectively reviewed. We included 373 of the patients underwent PNL operation due to renal pelvic stone, who were older than 18 years of age, who did not have any urinary tract abnormality, and had no previous history of open renal stone operation. Patients were divided into two groups according to the presence of severe hydronephrosis and absence of hydronephrosis. These two groups were compared in terms of age, gender, body mass index (BMI), number of stones, stone burden, operation duration, fluoroscopy time, hospitalization time, hemoglobin and creatinine change, complications, and stone free rate., Results: There was no statistically significant difference between the groups in terms of age, gender, BMI, stone number, stone size, stone density, operation duration, fluoroscopy time, and hospitalization duration. The mean change in hemoglobin was 1.5 g/dL in group 1 and 1.1 g/dL in group 2. This difference was statistically significant ( p  = 0.006). Postoperative blood transfusion was required for 3 patients (2.1%) in group 1 and 12 patients (5.1%) in group 2. This difference was statistically significant ( p  < 0.001)., Conclusion: Only the presence of severe hydronephrosis was found to be associated with the change in hemoglobin and postoperative blood transfusion.

Introduction: Various agents have been tested as preventive treatments for ischemia/reperfusion (IR) damage. In this study, we have investigated for the first time in the literature the efficacy of injection of amniomax (AMX) into testicular parenchyma, which is a commercial medium of rat amniotic fluid, in preventing testicular IR damage related to testicular torsion., Objective: This study aims to evaluate whether or not amniomax has an effect on experimental IR damage in rat testes using biochemical and histopathological methods based on data in the literature. Even if testicular torsion is repaired surgically in early term injury because of de IR damage still occurs. Is it possible to reduce the ischemia reperfusion injury with amniotic fluid and increase the success of treatment?, Study Design: 40 male Wistar albino rats were included. Four groups were formed with 10 rats in each group: Sham, Ischemia/Reperfusion (IR), injection 1 min before detorsion (AMX-BD), injection 1 min after detorsion (AMX-AD). Total Oxidant Status (TOS) and Oxidative Stress Index (OSI) were computed for oxidative stress, and Total Antioxidant Status (TAS) levels were computed for the antioxidant system, for both serum and tissue. Necrosis and microcalcification levels were assessed in the evaluation of testicular histology. P < 0.05 was considered statistically significant., Results: AMX-AD group has low necrosis degree than IR, Mean serum and tissue levels of TAS, TOS, and OSI parameters were respectively determined as; for TAS: 0.64 ± 0.11 and 0.96 ± 0.25 mmol Trolox Equivalent/L; for TOS: 6.71 ± 0.87 and 9.40 ± 1.03 μmol H 2 O 2 equivalent/L; for OSI: 11.94 ± 3.74 and 10.70 ± 4.23 arbitrary unit., Discussion: Our study has investigated for the first time in the literature the efficacy of amniotic fluid in preventing testicular IR damage, and used amniomax (AMX) for this purpose. The limitation of our study may be the small number of rat in the groups., Conclusion: We think an injection after detorsion is more favorable considering that the AMX-AD group demonstrated significantly lower levels of TOS in serum and tissue and OSI in serum, and significantly higher serum levels of TAS compared to the AMX-BD group, as well as the fact that the morphological protection effect was only observed for injections performed immediately after detorsion., Competing Interests: Conflict of interest The authors declare that they have no conflict of interest., (Copyright © 2021 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)

Objective: We aimed to determine the effect COVID-19 pandemic on the daily urology practice of the level 3 centre located in one of the most affected regions in Turkey. We also aimed to assess anxiety and depression levels of patients whose procedures and surgeries had to be postponed due to COVID-19-related restrictions., Methods: The number of patients admitted to the outpatient clinic, outpatient procedures, emergency consultation requests, hospitalised patients and the total number of surgeries between March 10, 2020 and June 15, 2020 were evaluated. These numbers were compared with the same period of 2019. Subsequently, patients who could not be operated or whose elective surgeries were postponed between March 10, 2020 and June 15, 2020 were determined(n:96). These patients were asked to fill out Beck Depression Inventory(BDI) and State-Trait Anxiety Inventory(STAI). The presence of difference between the baseline anxiety levels and the anxiety levels during the COVID-19 pandemic was investigated. Afterwards, these patients were divided into two groups based on planned procedures as oncological group (group1) and non-oncological group (group2). The presence of a difference between the anxiety and depression levels between the groups was investigated., Results: There was a drastic decline in number of patients in all assessed parameters. The least amount of change was seen in the number of emergency consultations. The evaluation of anxiety and depression scores of the patients showed a significant difference between their STAI-S and STAI-T scores (51.8 ± 9.3, 38.2 ± 7.5, respectively)(P < .001). STAI-S scores of the patients were found to be compatible with severe anxiety. The patients' mean BDI score was found to be 15 ± 8.9, which indicated mild depression. However, the age and STAI-S values were significantly higher in group1., Conclusion: We noted that anxiety and depression levels increased in patients whose operations were delayed because of pandemic-related restrictions, especially in oncological patients. We believe that an important contribution can be made to the protection of public health by planning advance psychosocial interventions for high-risk groups during pandemics., (© 2021 John Wiley & Sons Ltd.)

Objective: Hydronephrosis, which may be caused by kidney stones in the collecting system, may induce permanent flank pain and damage to kidney function. In this study, we aimed to examine whether the presence of hydronephrosis in the patient has an effect on the stone-free rates in flexible ureterorenoscopy (FURS) applications., Method: The study was carried out retrospectively with 164 patients. Stone size was calculated as volume in computed tomography. Preoperative patient demographic data, radiographic stone characteristics, operational findings, complication status and postoperative 1st month results were recorded., Result: The mean stone-free rate was found to be 61.5%. It was determined that age, gender, side, number, size and the Hounsfield Unit of the stone, the presence of preoperative extracorporeal shock wave lithotripsy (ESWL) history and the presence of hydronephrosis and its degree did not affect the stone-free rate. However, it was concluded that preoperative percutaneous nephrolithotomy (PNL) application and prolonged operation time were found to affect statistically significant stone-free rate. In addition, '2' was found to be the cut-off value for hydronephrosis in the receiver operating characteristic analysis., Conclusion: The presence of preoperative hydronephrosis does not decrease the success of FURS. However, it can be expected that the success of FURS will decrease as grade 2 or more severe grade of hydronephrosis. Therefore, we think that other treatment modalities such as ESWL and PNL should be prioritized in patients with grade 2 and more severe grade of hydronephrosis., Competing Interests: None., (AJCEU Copyright © 2021.)

Background: We compared outcomes of en bloc stapler ligation of the renal hilum with separate Hem-o-lok polymer clip ligation of the renal vessels during laparoscopic nephrectomy (LN)., Materials and Methods: Clinical data of patients who underwent LN for renal surgery from January 2009 to December 2015 were collected. Operation time, estimated blood loss, device malfunction rate, open conversion rate, complications and arteriovenous fistula (AVF) formation were evaluated., Results: En bloc stapler ligation and separate clip ligation were performed in 64 and 66 patients, respectively. The mean operative time was 106.8 ± 20.8 min (range: 70-165) in the en bloc stapler ligation group compared with 112.5 ± 24.1 min (range: 70-180) in the separate clip ligation group (P = 0.147). The mean estimated blood loss was 141.4 ± 124.1 ml (range: 25-600) in the en bloc stapler ligation group compared with 147.6 ± 112.4 ml (range: 25-450) in the separate clip ligation group (P = 0.767). The open conversion was required in 7/64 (10.9%) and 2/66 (3.0%) patients in the en bloc stapler ligation and separate clip ligation groups, respectively (P = 0.093). Stapler device malfunction occurred in 6 patients (9.3%). There were no statistically significant differences in overall complications (P = 0.726), minor (Grade 1-2) complications (P = 0.698) and major (Grade 3-5) complications (P = 0.716). No patient was diagnosed with AVF formation during overall median 33-month (interquartile range: 30, range: 24-96) follow-up., Conclusions: En bloc stapler ligation of the renal hilum during nephrectomy is an effective and safe technique. Although there is no reported AVF formation with en bloc stapler ligation of the renal hilum, longer follow-up is necessary., Competing Interests: None

Objective: Anxiety level in prostate cancer patients is common due to the increase in the incidence of prostate cancer diagnosis. We aimed to search for answers to the following questions such as whether there is preoperative anxiety in patients who will be operated for prostate cancer, what are the risk factors that may cause disease-induced anxiety and the type of surgery especially does robotic surgery reduce patient anxiety., Method: The patients who were taken into operation were divided into 2 groups as Open Radical Retropubic Prostatectomy-Group 1 and Robot-Assisted Laparoscopic Radical Prostatectomy-Group 2. Age, active surveillance history, preoperative prostate spesific antigen (PSA) level, prostate biopsy pathology result, time between prostate biopsy and operation, state and trait anxiety scores of these patients were recorded., Result: The study was conducted with a total of 149 patients; 61 patients in Group 1 and 88 patients in Group 2. The presence of active surveillance history, time between prostate biopsy and operation and state and trait anxiety levels were not found to be significant between both groups. However, it was concluded that the patients in Group 2 were significantly younger and operated with lower PSA and Gleason scores. The type of surgery had no effect on anxiety levels., Conclusion: Preoperative information about the surgical procedure was found to be an effective factor in reducing anxiety. Regardless of the type of surgery we recommend that patients' anxiety should be reduced by explaining the surgical procedure to patients enough and in a way that they can understand., Competing Interests: None., (AJCEU Copyright © 2021.)

Objective: To investigate the effect of testicular histopathology on the success of microscopic testicular sperm extraction (mTESE) and the factors that could predict the success of mTESE in patients with non-mosaic Klinefelter syndrome (KS)., Material and Methods: Forty-one KS patients diagnosed with non-obstructive azoospermia (NOA) who had undergone mTESE at our clinic were included in the study. The patients were divided into 5 groups according to the histopathology results: hyalinisation of tubules (HT), sertoli cell only (SCO), early maturation arrest (EMA), late maturation arrest (LMA), and hypospermatogenesis (HS). The groups were compared with regard to age, duration of infertility, hormone profile, testicular volume, and sperm retriveal rate. The clinical features of the patients with mTESE from whom sperm could or could not be obtained were also compared with the aim of investigating the predictive value of testicular histopathology and the other variables for prediction of the success of mTESE., Results: Sperm could be obtained through mTESE in 13 out of 41 patients (31.7%). A statistically significant difference was determined between the groups with regard to the rate of sperm collection. No significant difference was determined between the histopathology groups with regard to the other variables. A statistically significant difference was determined between the groups from whic sperm could be collected or not with regard to age, Johnsen criteria, SCO, EMA and LMA variables. Multi-variate analysis revealed that age and Johnsen score were the independent variables predictive for success of mTESE., Conclusion: The present study has revealed that impairment in testicular histopathology negatively affects the success of mTESE and that it is a predictive factor for the success of mTESE in patients with KS. Increased patient age was also determined to negatively affect the success of mTESE and the operation was demonstrated to be more successful before 34 years of age., (Copyright © 2019 Asociación Española de Andrología, Medicina Sexual y Reproductiva. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objectives: The aim of this study was to compare clinical outcomes and complication rates associated with semirigid (malleable) and inflatable penile prostheses (PPs) and investigate the factors that influence these complications., Material and Methods: The records of 131 patients who had undergone penile prosthesis implantation (PPI) in our clinic due to erectile dysfunction (ED) between January 2010 and March 2019 were retrospectively reviewed. The initial surgery included 116 primary implants and 15 men had two revision operations. Patients were assigned to two groups as semirigid (malleable) PPI (group 1) and inflatable PPI (group 2) patients, and obtained data were compared across these two groups., Results: Group 1 included 93 patients, while Group 2 included 38 patients. Postoperative complication rates of Group 1 were 8.6% (n = 8), and Group 2 were 21% (n = 8), and the comparison of postoperative complication rates revealed a statistically significant difference between the two groups (p = 0.025). The majority of these complications (50%) was constituted by mechanical failure associated with inflatable PPs. When patients were further segregated as those with and without diabetes type 2 (DM) and those who had and had not undergone radical pelvic surgery (RPS), the comparison of complication rates across these subgroups did not yield any significant difference., Conclusions: We determined in this study that semirigid (malleable) PPs were associated with lower complication rates compared to the inflatable group, particularly with regard to mechanic failure, and that DM and history of RPS did not make a difference in complication rates in patients planned to undergo PPI.

Background and objective : We investigated the ability of preoperative serum values of red blood cell distribution width (RDW), neutrophil lymphocyte ratio (NLR) and plateletcrit (PCT) to predict Fuhrman grades (FG) and tumor stages of renal cell carcinoma in patients who underwent radical nephrectomy. Materials and methods : Records of 283 patients that underwent radical or partial nephrectomy of renal masses at our clinic between January 2010 and April 2018, whose pathology results indicated renal cell carcinoma (RCC), and who had their FG and T1-4 N0M0 identified were retrospectively evaluated. The patients were divided into two groups based on their FG as low (I-II) and high (III-IV) and their T stages were similarly grouped as limited to kidney (pT1-pT2) and not limited to kidney (pT3-pT4). Results : Mean RDW, NLR, PCT cut-off values of the patients for FG and T stage were 15.65%, 3.54, 0.28% and 14.35%, 2.69, 0.28%, respectively. The RDW and NLR were determined to be statistically significant predictors of a pathologically high FG, whereas the PCT value was not a statistically significant predictor of high FG ( p = 0.003, p = 0.006, p = 0.075, respectively). The relationship of RDW, NLR and PCT values with a limited to the kidney pathological T stage revealed statistically significant correlations for all three values. Conclusions : We determined that only RDW and NLR were markers predicting FG, while PCT had no prognostic value. On the other hand, all three of these values were associated with a limited to the kidney pathological T stage in patients who underwent nephrectomy due to renal masses and whose pathologies suggested RCC.

Purpose: To evaluate the characteristics of images generated by magnetic resonance imaging (MRI) and changes in the mass-like lesion (MLL) during the follow-up of patients who underwent partial nephrectomy (PN) with the intra-operative use of hemostatic agents (HAs)., Methods: The records of patients who had undergone PN in our clinic due to renal mass between January 2013 and August 2018 were retrospectively reviewed. Our study included 47 patients who were administered one or more HAs during the PN and who received diffusion and dynamic MRI at the post-operative 2nd/4th Queryand 12th month., Results: MLL is defined as T2 heterogeneous, intermediate-signal intensity bolster-related mass with a pseudocapsule in the renal parenchymal defect. When we looked at the morphological changes of MLL, the mean largest axial dimensions of masses were 27.3 (range 12.2-44.7) mm in the first follow-up period (2nd/4th months) and 21.2 (range 11-44.7) mm in the 12th month follow-up period. The average change in size of MLL was - 0.66 mm/month. We did not see any significant relationship between observation of MLL in the post-operative follow-up MRI images and the use of HAs such as Surgicel ® , Spongostan ® , and autologous fatty tissue as well as the amount of the agents used in PN operations (p = 0.405, p = 0.159, respectively)., Conclusions: The distinction of MLL causing bolster-related mass and granulomatosis tissue from relapse/recurrence can be made based on the change in mass size observed in the MR images and image characteristics.

Purpose: To investigate the effects of all-trans retinoic acid (ATRA) in cisplatin (CP)-induced testicular damage in rats., Materials and Methods: Twenty-eight male Wistar rats were divided into four groups: Control, ATRA alone, ATRA+CP, and CP alone. Body weight, testicular weight, sperm count, sperm motility, percentage of abnormal sperm, total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI) in testicular tissue, and testicular histopathology were compared among groups., Results: The sperm count and motility significantly decreased and the percentage of abnormal sperm significantly increased in the CP group compared to the control and ATRA groups. CP+ATRA administration significantly increased the sperm count and motility, but reduced the abnormal sperm count. CP administration significantly increased TOS and OSI compared to the control group and the other groups. Administering CP+ATRA significantly decreased TOS and the OSI in testicular tissue and reduced spermatogenesis, but increased the Johnsen score., Conclusions: The destructive effects of CP treatment on testicular tissue and spermatogenesis were reduced by administering ATRA., Competing Interests: The authors have no potential conflicts of interest to disclose., (Copyright © 2019 Korean Society for Sexual Medicine and Andrology.)

Background: A staged ureteroscopic procedure is the generally preferred method in the treatment of bilateral ureteral stones due to the risk of bilateral injury. In this study we aimed to evaluate the safety and efficacy of bilateral same-session ureteroscopy (BS-URS) in terms of complications, operation time, serum creatinine, hospital stay and stone-free rates., Methods: A total of 75 patients who underwent BS-URS and holmium laser lithotripsy were evaluated, retrospectively. The patients were re-evaluated postoperatively after four weeks with ultrasonography, X-ray or computed tomography. Pre- and postoperative variables were analyzed. The results of BS-URS were also compared with unilateral URS cases performed in the same time period., Results: BS-URS was performed in 58 men and 16 women with a mean age of 46.3 years. The mean operating time was 69 min. In patients with stone burden ≥20 mm, the mean operative time was longer. Intraoperative complications were observed in eight patients, Clavien grade I in seven, and Clavien grade IIIb in one. Early postoperative complications included fever and hematuria were seen in 10.6% of the patients. One patient underwent secondary URS for residual stone. Stone free rate after four weeks was 98.6%. Overall complication and and stone-free rates were similar in BS-URS and unilateral URS groups (P>0.05). The mean operating time was significantly longer in BS-URS patients (P=0.001)., Conclusions: BS-URS is as safe and efficient procedure as unilateral ureteroscopy with high stone-free and minimal morbidity rates in the treatment of bilateral ureteral stones in appropriate patients.

Objective: We investigate the protective and therapeutic effects of ozone therapy (OT) in radiotherapy (RT)-induced testicular damage., Methods: Thirty healthy adult male Wistar rats divided into five groups consisting of six animals each as follows: (1) Control (C), (2) RT, (3) OT, (4) OT + RT, and (5) RT + OT group. Histopathological findings, Johnsen scores, thiobarbituric acid-reactive substances (TBARS), glutathione (GSH), superoxide dismutase (SOD), catalase, and glutathione peroxidase (GPx) levels were evaluated., Results: RT caused a significant decrease in testicular weight and Johnsen score compared to the control group. In addition, TBARS level was significantly higher, whereas GSH, SOD, catalase, and GPx levels were significantly lower in the RT group when compared to the control group. Pre and postRT OT significantly increased GSH, SOD, catalase, and GPx levels and decreased TBARS level. Furthermore, testicular weight and Johnsen score were increased with OT., Conclusions: The present study showed that OT is protective and therapeutic in radiation-induced testicular damage. OT may be beneficial to the patients who underwent RT., Competing Interests: None

The aim of this study is to investigate the effects of all-trans retinoic acid (ATRA) use on cisplatin (CP)-induced nephrotoxicty. Twenty-eight rats were randomly divided into four groups. The rats in the control group were injected a single dose of 1 ml/kg saline intra-peritoneally (IP) during 10 days. The rats in the ATRA group were injected a single dose of ATRA during 10 days. The rats in the ATRA+CP group were injected a single dose of CP on the fourth day of the 10 days of ATRA treatment. The rats in the CP group were injected a single dose of CP on the fourth day of 10 days without administering a treatment. After treatment, the groups were compared with regard to total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) levels in renal tissue and renal histopathology. The serum creatinine and urea values were statistically significantly higher in the CP group compared to the other groups. The serum creatinine and urea values were statistically significantly lower in the ATRA+CP group when compared to the CP group. Although the TOS and OSI levels were found to be lower in the ATRA+CP group compared to the CP group, the difference was not statistically significant. Administration of ATRA together with CP was observed to reduce the histopathologic destruction in the kidney and lead to mild tubular degeneration, vacuolization, and necrosis (57.1% grade 1; 28.6% grade2, and 14.3% grade 3 necrosis). The results of the present study have revealed that ATRA administration ameliorates CP-induced nephrotoxicity; however, further studies are required to identify this issue before clinical application.

Aim This study aims to evaluate the results of patients we treated with nephrectomy due to Xanthogranulomatous pyelonephritis (XGP) and the effects of kidney volume on the results. Patients and methods Records of 22 patients who underwent nephrectomy due to renal masses at our clinic between January 2008 and May 2018 and whose pathology results indicated XGP were retrospectively evaluated. The computed tomography (CT) measurement of the kidney volumes of the patients was calculated as the product of the longest length, width, and height of the kidney. The mean kidney volume of the patients was calculated and the patients were distributed into two groups: those that presented volumes below average (Group 1) and above average (Group 2). The patients' mean ages, operative duration, hospitalization days, differences in pre- and postoperative hemoglobin and creatinine levels, and postoperative complications were compared across groups. Results Group 1 consisted of 12 patients and Group 2 of 10 patients. The mean kidney volume of the patients was calculated as 33.4 cm 3 ± 26.0 cm 3 . The mean kidney volume of the patients was 15.8 cm 3 ± 9.9 cm 3 in Group 1 and 56.8 cm 3 ± 21.8 cm 3 in Group 2. There were no statistical differences between the two groups in terms of operative times, preop-postop hemoglobin (Hgb) levels and complications. Conclusion In cases where XGP is considered probable, the priority in preoperative CT must be to thoroughly evaluate the relationship of the kidney with the surrounding tissue and organs rather than to investigate the patients' kidney volumes., Competing Interests: The authors have declared that no competing interests exist.

Aim To investigate the effects of the additional presence of nephrolithiasis on the results of laparoscopic simple nephrectomy in patients with severe hydronephrotic non-functional kidneys. Patients and methods A total of 43 patients in whom severe hydronephrosis had been determined on spiral computerized tomography, who had a renal function of lower than 10% according to the dimercaptosuccinic acid (DMSA) renal scintigraphy, and who had undergone a laparoscopic simple nephrectomy due to persistent renal pain and/or recurrent urinary tract infection and/or unresolved hypertension with multidrug treatment, were included in the study. The patients were divided into two groups based on the presence of renal stone as those with stone formation (Group 1) and those without stone formation (Group 2). The groups were compared with regard to the patients' demographic characteristics, operation durations, pre- and postoperative hemoglobulin and creatinine levels, percentage of change of postoperative hemoglobulin levels, complications, transfusion requirements, and durations of hospitalization. Results Overall, there were 43 patients including 19 patients in Group 1 and 24 patients in Group 2. Although the durations of operations, the durations of hospitalization, and the rates of change of hemoglobulin were higher in the patients in Group 1, these differences were not statistically significant. Postoperative complications were observed in 21 (48.8%) of the 43 patients. Postoperative complications were observed in 13 patients in Group 1 and in eight patients in Group 2. This difference was determined to be statistically significant (p<0.01). Conclusions We observed that except for the postoperative complication rates, the laparoscopic nephrectomy results in patients with severe hydronephrotic non-functional kidneys with or without stone were similar., Competing Interests: The authors have declared that no competing interests exist.

Aim: To evaluate the effects of body mass index (BMI) ratio on semen parameters and serum reproductive hormones., Materials and Methods: The data of 454 patients who prsented to male infertility clinics in our hospital between 2014 and 2015 were analyzed retrospectively. Weight, height, serum hormone levels and semen analysis results of the patients were obtained. BMI values were calculated by using the weight and height values of the patients and they were classified as group 1 for BMI values ≤ 25 kg/m2, as group 2 for BMI values 25-30 kg/m2 and as group 3 for BMI values ≥ 30 kg/m2., Results: The mean values of BMI, semen volume, concentration, total motility, progressive motility, total progressive motile sperm count (TPMSC), normal morphology according to Kruger, head abnormality, neck abnormality, tail abnormality, FSH, LH, prolactin, T/E2, total testosterone and estradiol parameters of the patients were considered. Patients were divided according to BMI values in Group 1 (n = 165), Group 2 (n = 222) and Group 3 (n = 56). There was no statistically significant difference in terms of all variables between the groups., Conclusions: We analyzed the relationship between BMI level and semen parameters and reproductive hormones, demonstrating no relationship between BMI and semen parameters. In our study, BMI does not affect semen parameters although it shows negative correlation with prolactin and testosterone levels.

We compare the efficacy of intratesticular ozone therapy with intraperitoneal ozone therapy in an experimental rat model. For this purpose, 24 rats were divided into four groups including sham-operated, torsion/detorsion, torsion/detorsion plus intraperitoneal ozone (O-IP), and torsion/detorsion plus intratesticular ozone (O-IT). The O-IP ozone group received a 4 mg kg-1 intraperitoneal injection of ozone, and the O-IT group received the same injection epididymally. At 4 h after detorsion, the rats were sacrificed and orchiectomy materials were assessed histopathologically. Spermatogenesis in the seminiferous tubules and damage to the Sertoli cells were histopathologically evaluated in the testes using the Johnsen scoring system. i-NOS and e-NOS activities in the testis tissue were also evaluated. Torsion-detorsion caused a decreased Johnsen score and increased apoptosis of spermatogonial and Sertoli cells. Ozone injection prevented increases in Johnsen score and i-NOS level. e-NOS level of the O-IP group was significantly lower than that of the O-IP group, and i-NOS level of the O-IT group was significantly lower than that of the O-IP group. Local ozone therapy is more effective than systemic ozone therapy at improving IRI-related testicular torsion. Our study is the first to show that the efficacy of intratesticular implementation of ozone therapy is higher than that of intraperitoneal ozone therapy.

Objective: To examine the outcomes of the patients who underwent percutaneous nephrolithotomy with single-step dilatation technique in our clinic., Materials and Methods: A total of 932 patients who underwent percutaneous nephrolithotomy by using single-step dilation technique in the period between 2008 and 2015 in our clinic were included in the study. Data of the patients were analyzed, such as age, sex, stone burden, operative time, fluoroscopy time, operation success, and perioperative and postoperative complications., Results: An analysis of the data of 932 patients revealed similar operation success and complication rates as in the literature. Mean age of the patients included in the study was 48.9 years. Mean operative time was 66.6 minutes and mean fluoroscopy time was 139 seconds. Postoperative residual stone was detected in 17.1% of the patients. Postoperative fever was observed in 29 patients (3.1%), and sepsis developed in 11 (1.1%) of them. Additional postoperative procedures were required in 29 patients (3.1%). No patient was lost due to complications. Our data were compatible with the literature., Conclusion: Single-step dilation technique can be used as an effective and safe alternative dilation method in adult patients., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Small cell bladder carcinoma is a rare and frequently fatal disease. It can be distinguished from classical urothelial carcinoma microscopically and immunohistochemically. Small cell bladder carcinoma has histologically similar properties with other small cell carcinomas in other organs. It has a worse prognosis when compared to urothelial bladder cancer. Multimodal treatments are recommended although there is no widely accepted consensus regarding to the treatment algorithm because of its rarity. In this review, clinical properties and diagnosis of small cell bladder carcinoma, its histopathological and immunohistochemical properties and treatment modalities are examined.

Objectives: There are a number of studies about the effect of cigarette and alcohol on semen parameters in the literature. There is not a consensus on the relationship between use of cigarette and alchol and semen parameters in those studies. The number of studies in which cigarette and alcohol use are evaluated together is limited. This study was aimed to analyze the effect of cigarette and/or alcohol use on semen parameters., Methods: In this prospective study, 762 patients who applied to an hospital urology polyclinic between January 2015 and March 2015 due to infertility, were questioned for alcohol and cigarette use in anamnesis. The remaining 356 patients were included in our study. Then, semen analysis of the patients was performed. The patients were divided into five groups according to cigarette use, into five groups according to alcohol use and into four groups according to cigarette and/or alcohol use. Significant differences were analyzed between the groups in terms of semen volume, semen concentration, total motility, forward motility and morphological (normality, head anomaly, neck anomaly, tail anomaly) values., Results: According to cigarette use, only in group 4 (who use more than 20 package-years cigarette) semen volume was significantly lower than the control group (Mann-Whitney U, p = 0.009). There was no significant difference in any of the other parameters and groups compared with the control group (Mann-Whitney U, p > 0,05) CONCLUSION: According to our study, using more than 20 package-years cigarette decreases semen volume. The reason of this result might be the fact that the threshold value, from which the effect of cigarette and alcohol use on the semen parameters has to be determined.

Introduction: This study aimed to evaluate whether one-shot dilatation technique is as safe in patients with a history of open-stone surgery as it is in patients without previous open-stone surgery., Methods: Between January 2007 and February 2015, 82 patients who underwent percutaneous nephrolithotomy (PNL) surgery with one-shot dilation technique who previously had open-stone surgery were retrospectively reviewed and evaluated (Group 1). Another 82 patients were selected randomly among patients who had PNL with one-shot dilation technique, but with no history of open renal surgery (Group 2). Age, gender, type of kidney stone, duration of surgery, radiation exposure time, and whether or not there was any bleeding requiring perioperative and postoperative transfusion were noted for each patient., Results: The stone-free rates, operation and fluoroscopy time, and peroperative and postoperative complication rates were similar in both groups (p>0.05)., Conclusions: Our experience indicated that PNL with one-shot dilation technique is a reliable method in patients with a history of open-stone surgery.

Introduction: Obesity has been suggested to lower the success of percutaneous nephrolithotomy (PCNL). However, the relationship between abdominal fat parameters, such as visceral and subcutaneous abdominal adipose tissue, and PCNL success remained unclear. In this study, we aimed to investigate the effect of abdominal fat parameters on PCNL success., Methods: A total of 150 patients who underwent PCNL were retrospectively enrolled in this study. Group 1 consisted of patients who had no residual stones or residual stone fragments <3 mm in diameter while group 2 included patients with residual stone fragments ≥3 mm. PCNL procedure was defined as successful if all stones were eliminated or if there were residual stone fragments <3 mm in diameter confirmed by non-contrast computed tomography (NCCT) performed postoperatively. Preoperative NCCT was used to determine abdominal fat parameters., Results: Group 1 consisted of 117 (78.0%) patients while group 2 included 33 (22.0%) patients. On univariate analysis, stone number, stone surface area (SSA), visceral fat area (VFA), abdominal circumference on computerized tomography (ACCT), and duration of procedure were found to be predictive factors affecting PCNL success. Logistic regression analysis revealed that ACCT and SSA were independent prognostic factors for PCNL success., Conclusions: PCNL success was not affected by VFA, subcutaneous fat area (SFA) and body mass index (BMI) in our series. However, ACCT and SSA had negative associations with PCNL success. We conclude that both ACCT and SSA can be used as tools for predicting PCNL outcomes.

Primary renal cell carcinomas have rarely been reported in patients with crossed fused renal ectopia. We presented a patient with right to left crossed fused kidney harbouring renal tumor. The most frequent tumor encountered in crossed fused renal ectopia is renal cell carcinoma. In this case, partial nephrectomy was performed which pave way to preservation of the uninvolved both renal units. Due to unpredictable anatomy, careful preoperative planning and meticulous delineation of renal vasculature is essential for preservation of the uninvolved renal units.

Urinary system stones can be classified according to size, location, X-ray characteristics, aetiology of formation, composition, and risk of recurrence. Especially urolithiasis during pregnancy is a diagnostic and therapeutic challenge. In most cases, it becomes symptomatic in the second or third trimester. Diagnostic options in pregnant women are limited due to the possible teratogenic, carcinogenic, and mutagenic risk of foetal radiation exposure. Clinical management of a pregnant urolithiasis patient is complex and demands close collaboration between patient, obstetrician and urologist. We would like to review current diagnosis and treatment modalities of stone disease of pregnant woman.

Background: Anemia is the most common hematologic abnormality in bladder cancer (BC) patients. We evaluated the impact of preoperative anemia on oncologic outcomes in BC undergoing transurethral resection of a bladder tumor (TURBT) for the first time diagnosis., Materials and Methods: We retrospectively evaluated the data collected from 639 patients who underwent TURBT between January 2006 and September 2014 in our department. Of these patients, 320 qualified for inclusion in the study. The primary efficacy endpoint was the effect of preoperative anemia status on cancer-specific and overall survival. Independent t-test and chi-square analyses were performed to assess the effects of anemia on oncologic outcomes. Survival was estimated by using the Kaplan-Meier test., Results: There were 118 (36.9%) and 202 (63.1%) patients in the anemia (Group-1) and non-anemia groups (Group-2), respectively. The median follow-up duration was 68 months. Anemia was associated with decreased overall survival (<0.001). Comparison between cancer-specific survival of two groups did not show any statistically significant difference (p=0.17)., Conclusions: Preoperative anemia status of BC patients according to World Health Organization classification is associated with decreased overall survival, but not with cancer-specific survival. We think that preoperative hemoglobin levels should be considered in patient counseling and decision-making for additional therapy.

Objective: Bladder cancer (BCa) is the most common malignancy of the urinary tract. In this study, we aimed to evaluate the ability of preoperative neutrophil-to-lymphocyte ratio (NLR) to predict pathologic stage of at the time of first transurethral resection of bladder tumor (TUR-BT) in patients with BCa larger than 3 cm., Patients and Methods: Records of consecutive patients undergoing TUR-BT for BCa with a diameter >3 cm were reviewed. A total of 222 patients were eligible for analysis, and were divided into two groups: 162 patients in non-muscle-invasive BCa (NMIBC) group and 60 patients in muscle-invasive BCa (MIBC) group. Differences in preoperative blood parameters and NLR were evaluated between groups with an unequal variance t-test., Results: In the NMIBC group, 59 patients had low-grade and 103 high-grade papillary urothelial carcinomas. 60 patients had T2 stage carcinoma. The mean age of the patients was 71.8 and 75.7 years, and mean NLR was 3.44 ± 2.03 and 4.6 ± 2.8 in NMIBC and MIBC groups, respectively. In terms of NLR, there was a statistically significant difference between the NMIBC and MIBC groups (p = 0.005)., Conclusions: Our results showed that NLR might act as a significant predictive biomarker on the staging of BCa. Also, NLR could be used as a cost-effective, simple, common usable biomarker in urology clinic practice.

Introduction: To evaluate the impact of continuous positive airway pressure (CPAP) therapy on overactive bladder (OAB) symptoms in women with obstructive sleep apnea syndrome (OSAS)., Material and Methods: One-hundred and fifty women underwent an overnight polysomnography study between May 2014 and September 2014. Their voiding symptoms were evaluated using the OAB symptom score (OABSS) and International Consultation on Incontinence Questionnaire Short-Form at OSAS diagnosis and approximately 3-months after CPAP therapy. OSAS severity was assessed according to the apnea-hypopnea-index., Results: We evaluated 140 women and 111 of them (79.3%) reported symptoms consistent with OAB. There were no statistically significant differences between OSAS severity with a prevalence of OAB (p = 0.92). The prevalence of urinary incontinence (UI) was 35.7% (n = 50) and 39.6% (n = 44) in all patients and patients with OAB, respectively. There were no statistically significant differences between UI with OAB (p = 0.58). Baseline OABSS is comparable between OSAS severity (p = 0.143). After 3-months CPAP therapy, OABSS and ICIQ-SF sum scores were significantly decreased in patients with severe and moderate OSAS (p <0.01), however, change of OABSS sum score was insignificant in patients with mild OSAS (p = 0.44)., Conclusions: CPAP therapy improves the OAB, OABSS and ICIQ-SF scores in women with severe and moderate OSAS. OSAS-induced OAB may be alleviated following CPAP therapy.

Background and Objectives: Prostate cancer and inguinal hernia are common health issues in men aged more than 50 years. Recently, more data are accumulating that laparoscopic radical prostatectomy (LRP) and laparoscopic inguinal hernia repair (LIHR) can be performed in the same operation. The purpose of this study was to compare patients who underwent simultaneous extraperitoneal LRP (E-LRP) and LIHR with control patients who underwent only E-LRP in a matched-pairs design., Methods: Medical records of 215 patients were evaluated, and 20 patients who underwent E-LRP+LIHR were compared with 40 patients who underwent only E-LRP in a matched-pairs analysis. Preoperative clinical parameters (age, body mass index, prostate-specific antigen, clinical stage, Gleason score of the prostate biopsy, and prostate volume) and operative data (operation time, duration of catheterization, length of hospital stay, estimated blood loss, time to perform the anastomosis and its quality, and the percentage of patients with bilateral lymphadenectomy) were evaluated, as well as postoperative parameters (pathological stage, Gleason score, specimen weight, follow-up duration, biochemical recurrence, complication rates, and duration of postoperative analgesic treatment)., Results: No statistically significant differences were found in the preoperative and operative parameters between the 2 study groups. Pathological parameters and the follow-up period and complication rates were similar between the 2 groups., Conclusion: Performing LIHR and E-LRP during the same operation is safe and feasible in the treatment of patients with prostate cancer and inguinal hernia.

In renal transplantation surgery, double J stents (DJS) are often used to reduce complications, protect the anastomosis between ureter and bladder, provide drainage in ureteral obstructions and enhance healing if there is an ureter injury. Urinary tract infections, hematuria and irritative voiding symptoms are the early complications of DJS. Migration, fragmentation, encrustation and rarely sepsis are among the late complications of DJS. In this report we describe a renal transplantation case whose DJS stent was forgotten because the patient did not attend the regular follow-up and noticed 5 years after surgery.

Introduction: Radical prostatectomy (RP) is considered the best treatment for the management of localized prostate cancer in patients with life expectancy over 10 years. However, a complete recovery is not guaranteed for all patients who received/underwent RP treatment. Biochemical recurrence is frequently observed during the post-operative follow-up period. The main objective in this study is to evaluate the predictive factors of biochemical recurrence in localized prostate cancer patients who underwent RP surgery., Material and Methods: The study included 352 patients with prostate cancer treated by RP at a single institution between February 2004 and June 2014. Detailed pathological and follow-up data of all patients were obtained and analyzed to determine the results., Results: Mean follow-up duration was 39.7 months. 83 patients (23%) experienced biochemical recurrence (BCR) during the follow-up period. Mean BCR duration range was 6.56 (1-41) months. In multivariate logistic regression analysis, Gleason score (GS), PSA and extra-capsular tumour spread (ECS) variables were found to be statistically significant as BCR predictive factors., Conclusions: According to our study results, it is thought that PSA, GS and ECS can all be used for guidance in choosing a treatment modality for post-RP biochemical recurrence and metastatic disease as predictive factors. However, there is no consensus in this matter and it is still debated.

Introduction: Over the last two decades, minimally invasive treatment options for ureteropelvic junction obstruction have been developed and are bcoming more popular. Multiple series of laparoscopic pyeloplasty have demonstrated high success rates and low perioperative morbidity in pediatric and adult populations, for both the transperitoneal and retroperitoneal approaches. In this review, we aimed to analyze the current status of minimally invasive therapy of ureteropelvic junction obstruction., Material and Methods: A PubMed database search was conducted to examine minimally invasive treatments of ureteropelvic junction obstruction., Results: A large number of cases have been reported for adult patients, confirming that robotic pyeloplasty represents a viable option for either primary or secondary repair. Comparative studies demonstrate similar success and complication rates between minimally invasive and open pyeloplasty in both the adult and pediatric populations. A clear advantage, in terms of hospital stay, of minimally invasive over open pyeloplasty was observed only in the adult population., Conclusions: Studies have shown that minimally invasive pyeloplasty techniques are a safe, effective, and feasible in adult and pediatric populations.

Purpose: To examine the effectiveness of mitomycin-C and chemo-hyperthermia in combination for patients with high-risk non-muscle-invasive bladder cancer., Materials and Methods: Between November 2011-September 2013, 43 patients with high-risk non-muscle-invasive bladder cancer undergoing adjuvant chemo-hyperthermia in two centers were evaluated retrospectively. Treatment consisted of 6 weekly sessions, followed by 6 sessions. Recurrence and progression rate, recurrence-free interval and side effects were examined. Analyzed factors included age, gender, smoking status, AB0 blood group, body mass index, T stage and grade, concominant CIS assets. The associations between predictors and recurrence were assessed using multivariate Cox proportional hazard analyses., Results: A total of 40 patients completed induction therapy. Thirteen (32.5%) were diagnosed with tumor recurrence. Median follow-up was 30 months (range 9-39). Median recurrence-free survival was 23 months (range 6-36). The Kaplan-Meier-estimated recurrence-free rates for the entire group at 12 and 24 months were 82% and 61%. There was no statistically significant difference between patient subgroups. Cox hazard analyses showed that an A blood type (OR=6.23, p=0.031) was an independent predictor of recurrence- free. Adverse effects were seen in 53% of patients and these were frequently grades 1 and 2., Conclusions: Intravesical therapy with combination of mitomycin-C and chemohyperthermia seems to be appropriate in high-risk patients with non-muscle-invasive bladder cancer who cannot tolerate or have contraindications for standard BCG therapy.

Material and Method: The results of percutaneous nephrolithotomy applied to 716 patients in our clinic between January 2008 and January 2014 were retrospectively evaluated. Age, gender, urinary calculi size (mm(2)), urinary calculi localization, ESWL history, operation duration (min), fluoroscopy duration (sec), access type, reason of solitary kidney, hemoglobin drawdown (g/dl) and operation success of the patients with a solitary kidney were recorded. The patients having no preoperative and postoperative non contrast abdominal tomography were excluded from the study., Results: Fifteen of nineteen patients (79%) were men and 4 of them (21%) were women. The average age of the patients was 42.52 ± 16.72 (14-72). Ten patients had anatomical solitary kidney and nine patients had physiological solitary kidney. In fact counter kidney was non functional in 9 patients (47%) whereas there was agenesis in 2 (11%) and outcome of nephrectomy in 8 (42%) patients. In our study, presence of residual stone less than 4 mm at 1st month postoperative non contrast abdominal tomography was accepted as a successful result and accordingly our success rate was detected as 84%. Mean urinary calculi size was 405 ± 252.9 mm(2); urinary calculi localization was pelvic, lower pole, upper-middle pole, middle-lower pole and staghorn in 11 (58%), 4 (21%), 1 (5%), 1 (5%) and 1 (5%) patients, respectively; previous ESWL history was 16%; operation duration was 55.47-± 28.1 min and fluoroscopy duration 131.10 ± 87.6 sec; access type was subcostal in 79%, supracostal in 10.5% and multiple in 10.5%; hemoglobin drawdown was 1.75 ± 0.97 mg/dl., Conclusions: PNL can be effectively and safely administered for the treatment of solitary kidney. In the treatment of large urinary calculi in patients with a solitary kidney, PNL has some advantages such as short surgery duration, less complication, acceptable hemoglobin drawdown and high success rates. According to our study, PNL operation in patients with a solitary kidney is a good option for carefully and poisedly selected cases.

A 63-year old male was referred to our emergency unit due to acute renal failure. The level of serum renal function tests levels, blood urea nitrogen (BUN)/creatinine, were 63 mmol/L/848 μmol/L. CT (Computarised Tomography) scan showed a huge bladder stone (5 cm x 6 cm x 5 cm) with increased bladder wall thickness. Post-renal acute renal failure due to bilateral ureterohydronephrosis was diagnosed. The huge bladder stone was considered to be the cause of ureterohydronephrosis and renal failure. The patient was catheterised and received haemodialysis immediately. He received haemodialysis four times during ten days of hospitalization and the level of serum renal function tests levels (BUN/ creatinine) decreased 18 mmol/L/123 μmol/L. After improvement of renal function, we performed cystoscopy that demonstrated normal prostatic urethra and bladder neck and bilaterally normal ureteral orifices. Bladder wall was roughly trabeculated and Bladder outlet was completely obstructed by a huge bladder stone. After cystoscopy open, cystolithotomy was performed to remove calcium phosphate and magnesium ammonium phosphate stone weighing 200 g removed. Four days after operation the patient was discharged uneventfully and urethral catheter was removed on the seventh day. Post-renal acute renal failure due to large bladder stones is rare in literature. According to the our knowledge; early diagnosis of the stone avoid growth to large size and prevent renal failure.

Primary signet cell carcinoma of the prostate is a rare histological variant of prostate malignancies. It is commonly originated from the stomach, colon, pancreas, and less commonly in the bladder. Prognosis of the classical type is worse than the adenocarcinoma of the prostate. Primary signet cell adenocarcinoma is diagnosed by eliminating the adenocarcinomas of other organs such as gastrointestinal tract organs. In this case report, we present a case with primary signet cell adenocarcinoma of the prostate who received docetaxel chemotherapy because of short prostate specific antigen doubling time.

Malignant fibrous histocytoma (MFH) is the most common soft tissue sarcoma in adults. Urinary tract is a very rare location for MFH. Involvement of the bladder is more common in males and at the 6th decade of life. A case of MFH of the bladder with poor prognosis is presented. Prognostic factors for MFH are tumor grade, amount of invasion, age, tumor size, and histological type. Survival rate is very low and 3-year disease specific survival is approximately 40%.

Urothelial carcinoma developing in orthotopic ileal neobladder is an extremely rare entity. Fewer than 10 cases have been reported in the literature describing urothelial carcinoma recurrence in orthotopic ileal neobladder. We report a case of transitional cell carcinoma recurrence in orthotopic ileal neobladder after 11 years of surgery.

Objectives: To evaluate the potential benefits of laparoendoscopic single-site pyeloplasty over conventional laparoscopic pyeloplasty., Methods: Between October 2009 and January 2012, 39 patients were enrolled in a prospective study and randomized to undergo a laparoendoscopic single-site pyeloplasty (n = 19) or conventional laparoscopic pyeloplasty (n = 20). The outcomes in the two groups were compared by using Mann-Whitney U-test and χ(2) -test, and considering a P-value less than 0.05 as statistically significant., Results: There was no difference in blood loss (55.67 ± 6.71 vs 45.84 ± 5.22 mL, P = 0.60), transfusion rates (0% for both) and hospitalization time (2.12 ± 0.23 vs 2.06 ± 0.34 days, P = 0.72) between the laparoendoscopic single-site pyeloplasty and conventional laparoscopic pyeloplasty groups. The time to return to normal activities was shorter (8.65 ± 1.25 vs 11.53 ± 1.28 days, P = 0.01), and median operative time (195.21 ± 12.15 vs 145.62 ± 15.34 min, P = 0.001) was longer in the laparoendoscopic single-site pyeloplasty group compared with the conventional laparoscopic pyeloplasty group. No significant intraoperative or postoperative complications occurred in either group. Compared with conventional laparoscopic pyeloplasty, laparoendoscopic single-site pyeloplasty yielded better cosmetic results and patient satisfaction. The mean follow-up period was 19.7 months (4-28 months). The success rate was 95% in both the groups. Both the visual analog scale and the postoperative use of analgesics were significantly lower in patients who underwent laparoendoscopic single-site pyeloplasty., Conclusions: Our findings suggest that laparoendoscopic single-site pyeloplasty can offer faster recovery and higher patient satisfaction than conventional laparoscopic pyeloplasty. Thus, this novel technique promises to become the treatment of choice in minimally-invasive management of ureteropelvic junction obstruction., (© 2013 The Japanese Urological Association.)

Abdominoscrotal hydrocele is a rare entity with unclear etiology which may be diagnosed with general examination and ultrasound imaging. During examination it may misinterpreted as acute urinary retention of the bladder (globe-like) especially if associated with hydronephrosis. It should be treated surgically. Here we present a case of left abdominoscrotal hydrocele with accompanying left grade 2 and right grade 1 hydronephrosis.

In this study we report our initial robot-assisted laparoscopic radical prostatectomy (RALRP) experience for organ-confined prostate cancer with the first 112 cases between August 2009 and January 2011. The mean age was 61 (46-76) years. Gleason scores ranged between 4 and 9, and the mean prostate volume was 38.7 (15-115) ml. The mean follow-up time was 8.1 (1-18) months. The mean operative time was 174.7 (75-360) min, and the mean estimated blood loss was 141 (60-800) ml. A nerve-sparing procedure was performed bilaterally in 79 cases and unilaterally in 15 cases. All the complications seen (8 out of 112 patients, 7.1%) were grade 1 and 2 according to the Clavien classsification system. Postoperatively, five (4.4%) patients needed transfusion. Mean drain extraction time was 3.2 (2-15) days and mean hospital stay was 4 (2-18) days. The catheter was removed on postoperative day 8.5 (6-20). Surgical margin was positive in 13 (11.6%) patients. Forty-nine patients have 6 months and 30 patients have 12 months follow-up. The continence rate were 29.4, 64.2, 84.2, 91.1 and 96.6% immediately after catheter removal and at 1, 3, 6 and 12 months, respectively. No anastomotic stricture or urinary retention was seen in the follow-up period. RALRP is a safe and feasible technique in the treatment of localized prostate cancer. Our initial experience with this procedure shows promising short-term outcomes.

The aim of this study was to investigate p38-mitogene-activated protein kinase (p38-MAPK), nuclear factor-kappa B (p65-NF-kB) and inducible nitric oxide synthase (iNOS) expression in an experimental model of varicocele in the rat testis. Male Wistar albino rats (n = 18) were divided into three equal groups: control group, sham operated group and left varicocele-induced group. Malondialdehyde (MDA), nitric oxide (NO) and reduced glutathione (GSH) levels were biochemically assessed, and the p38-MAPK and NF-kB activity, and iNOS expression were immunohistochemically studied in the right and left testicles of rats from each group. The GSH levels were significantly decreased, whereas the level of MDA and NO was significantly increased in the testicular tissues of rats in varicocele group compared with those of the control and sham groups. There was a marked staining for iNOS, p38-MAPK and p65-NF-kB expression in rats of varicocele group compared with the sham group. There was no positive staining in rats of control group. There were significant differences in biochemical, histological and immunohistochemical studies, but no significant differences were noted between other groups. p38-MAPK and p65-NF-kB activation, and iNOS expression have a significant role in varicocele-induced testicular dysfunction., (© 2011 Blackwell Verlag GmbH.)

Objective: We present the transperitoneal and retroperitoneal approaches to laparoscopic partial nephrectomy and compare the outcomes of each technique., Methods: Between December 2006 and March 2010, retroperitoneal laparoscopic partial nephrectomy (RLPN) was performed in 23 patients and transperitoneal laparoscopic partial nephrectomy (TLPN) in 26 patients. They were compared regarding surgical technique, operative parameters, postoperative recovery and follow-up data. The 2 approaches used similar operative techniques to control parenchymal bleeding., Results: The patient demographics were similar in both groups. The mean tumour size was 3.1 cm in the retroperitoneal group and 3.4 cm in the transperitoneal group. The difference was not statistically significant (p: 0.095). The mean operative time was significantly longer in the transperitoneal group (215 vs 185 minutes, p: 0.031). The mean warm ischemia time difference was not statistically significant (25 vs 28 minutes, p: 0.102). The mean estimated blood loss (EBL) was greater in the transperitoneal group (254 vs 204 cc, p: 0.003). Moreover, the mean hospital stay was 4.1 days in the RLPN and 4.3 days in the TLPN group (p: 0.303) The difference was not statistically significant. The median follow-up was 11 months (range: 2 to 35) in the retroperitoneal group and 13 months (range 1 to 36) in the transperitoneal group., Conclusions: Our experience has shown that laparoscopic partial nephrectomy is a safe, feasible technique for patients with small exophytic renal tumours. We believe that the decision regarding the approach should be based on the tumor location on the kidney surface.