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Are Prostate Cancer Screenings Performed in Compliance with Cancer Guidelines? Aim: This study aims to examine whether our region's Prostate Cancer (PCa) screening programs comply with the European Association of Urology (EAU) Guidelines. Method: This study was conducted as a retrospective, cross-sectional study between April 2014 and July 2022. Two hundred seventy patients who applied to our clinic for various reasons and were diagnosed with PCa were included in the study. Characteristics of the patients, such as age at diagnosis, comorbidities, age at first PSA examination, and PSA values, were recorded. Results: At the time of diagnosis of cancer, the mean age of the patients was 67.42±8.64 (43-91) years, and the PSA value (median±IQR) was 9.58±19.43 (1.83-3437) ng/ml. The age of the first urological examination was 63.14±8.31 (40-91) years. Only 31.3% of the patients were regularly followed up by a specific urology doctor. When the distribution of cancer was investigated, there were in the 40-50 age range 5(%1,8), 50-60 age range 44(%16,1), 60-70 age range 111(%40,7), 70-80 age range 86(%31,5) and over the 80 age 24(%8,8) patients. While 138(51.1%) patients had local and good tumor characteristics, 59(21.9%) patients were diagnosed with metastatic findings.The mean age of the patients at the time of cancer diagnosis was 67.42±8.64 (43-91) years. PSA value (median±IQR) at the diagnosis was 9.58±19.43 (1.83-3437) ng/ml. When the distribution of cancer according to different decades of life was examined, there were 5 (%1.8) patients in the 40-50 age range, 44 (16.1%) in the 50-60 age range, 111 (40.7%) in the 60-70 age range, 86 (31.5%) in the 70-80 age range, and 24 (8.8%) after the age of 80. While 138 patients (51.1%) had local and benign tumor features, 59 (21.9%) patients were diagnosed with metastatic findings. Only 31.3% (61/195) of the patients were under regular follow-up by a specific urology doctor. Conclusion: It was found that the screening of prostate cancer, the most common type of cancer in men, was not performed by the guidelines, and as a result, diagnosis and treatment were delayed. It was determined that many patients lost the chance of curative treatment. In this disease, where early diagnosis is vital for effective treatment and preservation of quality of life, it is essential to follow up with aging men in accordance with the guidelines. It may be beneficial to periodically train and follow up with all health professionals interested in this issue. Key Words: EAU Guidelines, Prostate cancer, Age

For diagnosis of prostate cancer, prostate biopsy accompanied by TRUS is the current method applied today. The aim of this study was to compare targeted antibiotic prophylaxis, chosen according to rectal swab results before the procedure, with routinely administered prophylaxis and to investigate the effect on infective complications. The study included 140 patients with 12-quadrant prostate biopsy accompanied by TRUS in our hospital from 2018 to 2020. The first group had antibiotherapy prophylaxis administered according to the results of rectal swabs before the procedure. The second group had routine ciprofloxacin prophylaxis administered. Patients were followed prospectively for 1 month after the procedure. When the mean age, systemic diseases and distribution in both groups are examined, there was no significant difference observed. Fever (> 38.5 °C) was observed in 3 patients in the rectal swab group (4.3%), while it was identified in 10 people in the control group (14.1%) (p = 0.047). Major complications were observed in 3 people in the rectal swab group (4.3%) and in 7 people in the control group (9.9%) (p = 0.012). The results of the study identified that routine administration of targeted antibiotic prophylaxis may be more effective in preventing infective complications compared to standard prophylaxis. Targeted prophylaxis is recommended for risky patients in the guidelines. However, the lack of difference between the groups in terms of age and comorbidities supports the need to administer targeted prophylaxis not just to risky patients but as well as routine practice.

Introduction: The purpose of this study was to investigate and compare the effects of radiofrequency thermotherapy (RF) thermotherapy and transurethral resection of the prostate (TURP) on nocturia and associated quality of life in patients diagnosed with benign prostatic obstruction (BPO) under medical treatment who have complaints of persistent nocturia. Methods: The results of patients who underwent RF thermotherapy and TURP procedures between February 2019 and February 2022 were examined, and their three-month results were compared based on their uroflowmetry values, International Prostate Symptom Score (IPSS) values, nocturia frequency, and Nocturia Quality of Life Questionnaire scores. Results: While the frequency of nocturia in the RF thermotherapy group that was 4.5±1.6 before the procedure decreased to 2.3±1.4 after the procedure (p=0.002), this value in the TURP group decreased from 5.1±2.42 to 3.9±2.1 (p=0.044). RF thermotherapy was found to be more effective than TURP (p

In spite of extraordinary developments in diagnostic and treatment methods for prostate cancer (PCa), the reason for this disease is not known. Our study aimed to compare men in the PCa group with a control group in terms of sexual behavior like partner numbers and ejaculation frequency, and inflammatory parameters examined in serum.This study was performed prospectively between 2013 and April 2020 and the record system was kept by a single doctor. Patients were prospectively recorded by a single person. Patients with diagnosis of PCa were compared with a control group in terms of sexual behavior and in terms of inflammatory parameters like neutrophil lymphocyte ratio (NLR, neutrophil count/lymphocyte count), systemic inflammatory index (SII, neutrophil count x platelet count/lymphocyte count).In this study, median marriage age was 18 ± 6 years in the control group and 20 ± 2.97 in the PCa group (P = .001). The median lifelong partner number was observed to be 1 ± 1 in the control group and 1 ± 9 in the PCa group (median ± IQR). Additionally, lifelong median ejaculation frequency was determined as 12 ± 5 for controls and 10 ± 4 for the PCa group. Inflammatory markers examined in serum and SII scores were observed to be statistically significantly increased in the cancer group.The sexual behavior and inflammatory parameters among patients with PCa diagnosis were identified to be significantly high compared to the control group and appear to be possible correctable risk factors. Informing men about sexual behavior from an early age and taking precautions for people at risk in the early period may be protective against this disease.

Pandemiler, genis bir cografi alanda morbidite ve mortaliteyi buyuk olcude artirabilen ve onemli ekonomik, sosyal ve politik bozulmaya neden olan buyuk olcekli bulasici hastalik salginlaridir. 1918’de Ispanyol gribi, 1957’de Asya gribi, 1968’de Hong Kong gribi ve 2009’da domuz gribi morbidite ve mortalite acisindan cesitli ozelliklere sahip pandemiler olarak biliniyordu. Daha yakin donemlere bakildiginda ise 2003’de SARS, 2009’da influenza (H1N1), 2012’de MERS, 2014’de Ebola, 2016’da Zika virusu ve gunumuzde Cin'in Wuhan sehrinde, Aralik 2019’da baslayan ve tanimlanan yeni koronavirusun neden oldugu Covid-19 pandemisi dunya uzerinde bircok insani olumsuz etkilemis ve cok sayida insanin olumune sebebiyet vermistir.Uluslararasi toplum, pandemilerin etkilerine hazirlanma ve azaltma yolunda ilerleme kaydetmistir. 2003 siddetli akut solunum sendromu (SARS) salgini ve kus gribinin yarattigi tehditle ilgili artan endiseler bircok ulkeyi salgin planlari gelistirmeye itti. Bu gelismelere ragmen, kuresel pandemi hazirliklarinda onemli bosluklar ve zorluklar bulunmaktadir. Pandemi sirasinda hastalarin karsilanmasinda ve tedavi planlamasina yonelik bircok ulke temel gereksinimleri karsilayamamistir. Gunumuz tibbi gelismelere ragmen bu yeni pandemi hastaligin zamaninda tespiti, temel bakim ihtiyaclari, temaslilarin izlenmesi, karantina ve izolasyon prosedurleri ve kuresel koordinasyon ve mudahale de dahil olmak uzere hem saglik sektoru hem de saglik sektoru disinda bircok zorluklar yaratmistir. Covid-19 pandemisi ortaya ciktigi 2019 yili sonrasi dunyayi hizli bir sekilde etkilemis, toplumun tum kesimlerinde sikinti, panik ve endiseyi artirdigi saptanmistir. Covid-19 pandemisi tum dunyada kabul edilen tibbi yaklasim yontemlerinin hizli bir sekilde yeniden yorumlanmasina neden olmustur.Bu hastalik hakkinda basta bildiklerimizin kisitli olmasi tibbi yaklasimlarda zorluklari da beraberinde getirmistir. Dunya genelinde tip otoriteleri bu hastaliga yaklasim konusunda cok hizli degerlendirmeler yapmaya ve yeni klavuzlar yayinlamaya basladilar. Bircok ulkede tibbi imkanlarini ve olasi tedavi yaklasimlarini goz onune alarak bircok yeni klavuz yayinlandi. Bu kitapta bu yeni yaklasimlari derlemeye calistik. Tum arkadaslarimizin ozverili calismasi sonucu ortaya cikan bu eserin saglik camiasina faydali olmasi dileklerimizle emegi gecenlere tesekkurlerimizi sunariz.

The Aim of this study was to investigate the efficacy of the new bipolar radiofrequency prostate thermotherapy method for those with high potential surgical risk and also for patients with a chronic catheter.103 patients attending our clinic due to BPO and related complaints with high ASA score had outcomes after the procedure recorded prospectively and investigated retrospectively. Qmax, prostate volume, IPSS score, quality of life score, and presence of catheters were recorded before the procedure and analyzed with the outcomes after the procedure.The ASA scores were calculated as 3.0 ± 1.0 (IQR). Before the procedure, Qmax values (mean (SD)) were 5.11 ± 5.37 ml/s, while in the 6th month after the procedure Qmax values were identified as 10.45 ± 3.8 ml/s (Bipolar RF thermotherapy appears to be an effective method for patients with BPO who cannot be operated. Due to the surgical risks of patients dependent on the catheter in spite of receiving medical treatment, it is a good alternative to remove catheter dependence. It may be one of the methods that should be remembered, especially in this patient group.

Purpose: To compare the effects of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PNL) on postoperative pain and their differences in terms of the postoperative need for ana...

WOS: 000446380100003 PubMed: 30012025 Purpose: Today, the long-term effects of partial exposure of cholinesterase on the kidney continue to be a research topic. in this study, we aimed to histopathologically investigate the possible effect of acute toxicity due to fenthion, an organophosphate (OP) compound, on the kidneys. Methods: in all, 21 rats were randomly divided into three groups. Experimental group was each administered intraperitoneal 0.8 g/kg fenthion within physiologic serum. Sham group was only administered intraperitoneal physiologic serum. the control group continued normal nutrition with no procedure performed. After 24 h, all rats were sacrificed by cervical dislocation. Half of the recipient kidney tissues were examined histopathologically and the other half biochemically. Results: No histopathological findings were found in the control group. Rats in the experimental group were observed to have epithelial cell disorganization in tubules, moderate epithelial cell loss, and degeneration. Again, expansion of tubules, vacuolization of tubular epithelial cells, and tubular structure approaching atrophy were observed, with cells approaching apoptosis and common hemorrhage noted although rats in the sham group were observed to have mild tubular degeneration. Conclusions: It should not be forgotten that one of the causes of systemic complaints linked to acute toxicity exposed to the OP compound of fenthion may be cellular injury to glomerular and tubular structures in the kidneys.

WOS:000435474400002 PubMed: 29924211 Purpose: To evaluate the clinical stenosis or precursor histological changes that ureteral access sheaths commonly used in ureteroscopic surgeries may cause in the long term in ureter. Methods: In this study, the animals were divided into 9 groups and according to their groups, ureters of the rabbits were endoscopically fitted with 2F and 3F ureter catheters. The catheters were left in place and withdrawn after a specified period of time. All the ureters were excised and evaluated macroscopically, microscopically and histologically. Ureter diameters were measured and FGF-2 (+) labeled fibroblasts were counted in connective tissue as stenosis precursors. Results: Macroscopically or microscopically, no stenosis was found in any group. The ureter diameter of the group that were catheterized for the longest time with the catheter that had the widest diameter was significantly lower than the group with the shorter duration and the catheter with the narrower diameter and the control group. When the groups were compared in terms of their FGF values, there was a significant difference in FGF-2 counts at all three ureter levels (p < 0.05). Conclusion: The use of ureteral access sheath may lead to histological changes, as its diameter and duration increase.

Storage symptoms are pathology with increasing frequency and importance among elderly men. The efficacy and advantages of the new bipolar radiofrequency prostate thermotherapy method were investigated for storage symptoms in elderly.The outcomes for 150 elderly patients with significant storage symptoms accompanying voiding symptoms were investigated. The patients' Qmax (maximum urinary flow rate), prostate volumes, OAB-V8 (overactivebladder-Validated 8) and quality of life scores were questioned before the procedure and 1st month and 6th month.OAB-V8 total score had mean value of 26.3, with values identified as 16.2 (The bipolar radiofrequency thermotherapy method provides significant improvement of storage symptoms in elderly men. It is thought that this method has advantages in terms of its effects on storage and voiding symptoms in the elderly.

To compare the success and complication rates and advantages and disadvantages of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PNL) methods for the upper calyceal renal stones between 10 and 20 mm.The files of 124 patients who had upper calyceal renal stones in diameter 10-20 mm were analyzed retrospectively. Sixty-one patients were randomized as Group 1 and 63 as Group 2. The parameters as success and complication rates, fluoroscopy and operation times, preoperative and postoperative hemogram (Hb) levels, and need of blood transfusion were saved and then groups compared. Complication rates and need of second procedure numbers between groups were evaluated according to modified Clavien classification.Demographic features and success and complication rates between groups were similar. Hospitalization time was 1.0 ± 0.1 day for Group 1 and 2.3 ± 1.4 days for Group 2. When preoperative and postoperative Hb difference was evaluated, 0.1 ± 0.3 mg/dL decrease was noticed for Group 1 and 1.6 ± 0.8 mg/dL decrease for Group 2. Mean operation time for Group 1 was 53.6 ± 15.1 minutes and mean fluoroscopy time was 20.1 ± 8.9 seconds for Group 1; for Group 2, these values were 67.8 ± 16.2 minutes and 53 ± 15.0 seconds, respectively. As a result, mean operation time and fluoroscopy time, hospitalization time, and Hb decrease levels were found less and as statistically significant for Group 1.RIRS and PNL methods both have the same success and complication rates for upper calyceal renal stones between 10 and 20 mm. However, we think that RIRS method should be preferred for suitable patients because it is a more noninvasive method and has advantages of some operation parameters over PNL.

Priapism is an uncommon disorder, and nonischemic priapism is seen less frequently in children, generally after trauma. Although it seems to be an advantage that urgent intervention is not required because of no cavernous ischemia, it is likely to be misdiagnosed because of the asymptomatic potential. We aimed to present a case of posttraumatic nonischemic priapism.

To compare the effectiveness and reliability of retrograde intrarenal surgery (RIRS) and micro-percutaneous nephrolithotomy (micro-perc) for the management of kidney stones in pediatric patients.A retrospective analysis was made of pediatric patients aged18 years with kidney stones that ranged from 10 to 20 mm in size, who underwent RIRS (n = 36) or micro-perc (n = 45) in referral centers.In the RIRS group, the mean age of patients was 8.39 ± 4.72 years and in the micro-perc group, it was 5.62 ± 4.50 years (p = 0.01). The mean stone size was 12.80 ± 3.03 mm in the RIRS group and 13.97 ± 3.46 mm in the micro-perc group (p = 0.189). The success rate was 86.2% (n = 31) in the RIRS group and 80.0% (n = 36) in the micro-perc group (p = 0.47). The mean complication rate was 16.6% and 13.3% in the RIRS and micro-perc groups, respectively (p = 0.675). Hospital stay and radiation exposure were significantly lower in the RIRS group (all p 0.001). The mean anesthesia session was 1.94 in the RIRS group and 1.26 in the micro-perc group (p 0.001). The mean hemoglobin drop was 0.53 ± 0.87 g/dL in the micro-perc group, and none of the cases required blood transfusion.The results of this study suggested that micro-perc and RIRS were highly effective methods for the treatment of moderately sized renal stones in children, with comparable success and complication rates. Patients and their parents should be informed about the currently available treatment options, and of their efficacy and safety. However, further clinical trials are needed to support these results.

Aim Inthe literature, studies investigating the effects of isotretinoin on spermatogenesis are controversial and there is no consensus. In this study, the aim was to investigate whether isotretinoin has any effects on spermatogenesis and, if present, whether these effects are dose linked or not. Materials and methods Twenty-two rats were divided into four groups. The first group (n=5) was administered 7.5 mg/kg/day and the second group (n=5) was administered 30 mg/kg/day isotretinoin dissolved in sunflower oil orally for 4 weeks. Group 3, the sham group (n=6), was administered only sunflower oil. Group 4 was the control group and was administered standard feed and water. At the end of the fourth week, all rats were killed and histologic investigation was performed. Sperm motility, sperm count, sperm vitality, seminiferous tubule diameters, germinal epithelium thickness, and apoptotic indices were assessed. Follicle-stimulating hormone, luteinizing hormone (LH), and testosterone levels were measured in serum. Results There was a significant degree of reduction in sperm motility, sperm viability, seminiferous tubule diameters, and germinal epithelium thickness in the first and second groups compared with the control group. Sperm count was found to be significantly reduced in the second group compared with the other groups. Follicle-stimulating hormone and luteinizing hormone values were not observed to change in all groups. Conclusion This study concluded that both high-dose and low-dose isotretinoin disrupted spermatogenesis; however, it did not affect the hypothalamic–pituitary–gonadal axis.

Background/aim: The artificial urinary sphincter (AUS) is still one of the best options for incontinence treatment. It may also have an advantage for revision or reimplantation in the management of complications. In this study we aimed to discuss the etiological factors for AUS reimplantation and effects of these etiological factors on success rates, patient satisfaction rates, time to reimplantation surgery, and complications.Materials and methods: Data from 30 patients for whom AUS reimplantation was performed were analyzed retrospectively. Incontinence due to fluid loss from the cuff or reservoir balloon, inability of the cuff to adequately compress the urethra, and devices that were thought to have completed their lifespans were defined as mechanical reasons while incontinence caused by conditions such as cuff erosion and infection were defined as nonmechanical reasons. Patients who went through reimplantation due to mechanical and nonmechanical causes were included in Group 1 and Group 2, respectively. Success rates, patient satisfaction rates, time between the implantation of the first and second AUS, and complications were compared between the groups.Results: The mean follow-up period was 79 (3-308) months for patients who went through primary AUS implantation due to postprostatectomy incontinence. Our success rates were found as 75% and 66% in Group 1 and Group 2, respectively. The differences between the groups in terms of success and patient satisfaction rates were not statistically significant, while the time to reimplantation was longer in Group 1 and statistically significant.Conclusion: Reasons for AUS reimplantation may affect the success and patient satisfaction rates. Our success rates of AUS performed for nonmechanical reasons were slightly lower, but not statistically significantly so. AUS reimplantation may take a longer time if mechanical failure is detected.

This study aimed to compare the outcomes of standard percutaneous nephrolithotomy (PCNL) to PCNL with intraoperative antegrade flexible nephroscopy (IAFN) for treating stones of staghorn nature. We retrospectively analyzed patients treated using PCNL between January 2007 and July 2013. A total of 1250 patients were treated using PCNL, and 166 patients had staghorn stones. All patients had been subjected to a complete blood count, routine biochemical analyses, coagulation tests, a complete urine analysis, and urine cultures. Patients with a positive urine culture had been treated with appropriate antibiotics until the urine culture became negative. After purchasing a flexible renoscope in March 2012, we routinely used this tool to improve the stone-free (SF) rate. The 105 patients who underwent standard PCNL prior to March 2012 were classified as Group 1, and the 61 patients who underwent PCNL + IAFN after that date were classified as Group 2. The two groups had similar and homogeneous demographic data. The fluoroscopy and total operative times were significantly higher in Group 2 than in Group 1 (p

OBJECTIVE: In this paper, we present our experience with percutaneous nephrolithotomy (PNL) in a pediatric patient group. MATERIAL AND METHODS: From June 2007 to September 2010, we performed PNL on 57 pediatric patients. children with a mean age of 7.56 (1-15) years. RESULTS: Study population consisted of 30 male, and 27 female children with a mean age of 7.56 (1-5) years. Mean stone burden was calculated to be 312.2 (95-1550) mm(2). Percutaneous access was performed under fluoroscopy. Tract dilatation was accomplished with 20 F Amplatz dilators. Pneumatic lithotripsy was used to fragment the renal calculi. Mean operating time was 34 (3-80) minutes. With a single session of PNL, complete stone-free rates were achieved in 55 (96.4%) patients. Residual fragments were remained in 2 (3.5%) patients. Two patients had a febrile episode without signs and symptoms of bacteremia. Subcostal access was used in all of the patients, and none of the patients had any complications. CONCLUSION: Based on our experience, we conclude that PNL is a safe and effective method in the management of pediatric stone disease.

factPresentation 42 yaşında erkek hasta ilişki sonrası penil şişlik ve hematom nedeni ile acil servise başvurdu.Hasta opere edildi. Tunika albüginea bütünlüğü tam idi. Rüptüre süperfisial dorsal ven bulundu ve ligate edildi.Postoperatif seksüel fonksiyon ve ereksiyon tamamen normal idi.Penisin süperfisial dorsal ven ruptürü nadir görülür ancak ağrısız şişlik ve hematom olması, ani detümesans olmaması gibi klinik durumlarda penil fraktür ayırıcı tanısında akılda tutulması gerekir 42-year-old male admitted to the emergency department with penile swelling and hematoma after a sexual intercourse.The patient had gone under surgical exploration. There was not any problem in the integrity of tunica albugenia. The superficial dorsal vein which was ruptured was found and ligated. Postoperative sexual function and erection was completely normal.Rupture of the superficial dorsal vein of the penis occurs rare, but it must be kept in mind in the diagnosis of penile fracture in clinical conditions such as lack of sudden detumescence, painless penile swelling and hematoma

Objective: To compare the results of percutaneous nephrolithotomy (PCNL), shock wave lithotripsy (SWL), and retrograde intrarenal surgery (RIRS) for 1- to 2-cm lower pole kidney stones. Patients and Methods: This retrospective study was based on data collected from the files of patients between January 2007 and May 2012. The files of 383 patients (221 SWL, 144 PCNL, 38 RIRS) were evaluated. The groups were compared for stone size, success rate, and complication rate using the modified Clavien grading system. Results: The stone burdens of the groups were similar (p = 0.36). The success rates were 76, 94, and 73%, respectively, in SWL, PCNL, and RIRS. The highest stone-free rate was in the PNL group (p < 0.05). When the complication rates were evaluated using the Clavien grading system, they were determined to be 13% in PCNL, 3% in SWL, and 5% in RIRS. Especially GII and GIII complications were more common in the PCNL group (p < 0.05). Conclusion: PCNL seems to be the most successful but most invasive method. However, with relatively low complication rates, SWL and RIRS are other techniques to keep in mind. To determine the first-line treatment, prospective randomized studies with larger series are needed.

Objective: Creation of the access tract is an important step in percutaneous nephrolithotomy (PNL). In this study, we compared the efficiency and safety of Amplatz, Alken, and balloon dilation methods in the creation of the access tract. Materials and Methods: Data from 487 PNL patients admitted to 517 renal units in 3 centers were analyzed. The Amplatz (280 patients), Alken (142 patients), and balloon (95 patients) dilation methods were compared for their success, duration of the dilation, injury to the collecting system, durations of fluoroscopy and surgery, stone-free and complication rates, pre- and postoperative hematocrit levels, and need for blood transfusion. Results: The dilation methods did not significantly differ with respect to patient demographic data, mean stone area, decrease in hematocrit, need for blood transfusion, unsuccessful tract dilation, injury to the collecting system, stone-free rate, and rate of postoperative complications. The mean fluoroscopy times during Amplatz, Alken, and balloon dilation were 288.52 ± 164.67, 287.34 ± 164.99, and 169.23 ± 21 seconds, respectively. The mean duration of surgery was 96.48 ± 46.07, 94.72 ± 42.25, and 78 ± 25.96 minutes, respectively. The duration of tract creation was 328.67 ± 172.99, 325.14 ± 175.70, and 203.50 ± 32.76 seconds, respectively. The durations of surgery and tract creation were significantly shorter in the balloon dilation group. Conclusion: None of the dilation methods was significantly superior in terms of surgical success, efficiency, or safety. Although balloon dilation was advantageous with respect to time parameters, the role of surgical experience should not be ignored. © Copyright 2016, Mary Ann Liebert, Inc. 2016.

Objective: To present our experience in laparoscopic adrenalectomy. Material and Methods: We have reviewed the records of our 64 adrenalectomy cases between August 2007 and October 2014 retrospectively. Of these cases, 63 had unilateral masses (25 right-sided, 38 left-sided) while only one patient had bilateral masses. The mean age of the patients was 46.72 years (26-81) and 44 (68.75%) patients were women and 20 (31.25%) were men. The average mass size was calculated as 35x29 mm and 48x34 mm in functional and non-functional adenomas, respectively. Results: Of the 64 patients, 48 were referred by endocrinology clinics while 16 patients were diagnosed incidentally. Fourteen patients had history of previous intra-abdominal surgery and five of them were continued as open surgery due to intraperitoneal adhesions. Mean duration of operation was 94±42 minutes and mean hospitalization time was 3.1±1,6 days. We did not encounter any major complications and recurrent or residual masses. Conclusion: Laparoscopic adrenalectomy is a safe method that can provide comfort to patients and surgeons in appropriate cases.

Genitourinary and colon tumors which constitutes frequent sources to metastatic tumors of the penis, are relatively more common tumors in the society. Though its rich vascularization, metastatic tumor of the penis is very rare. This can be considered to be a gladsome situation in terms of hopeless survey of metastatic penile tumors. The main goal of treatment is to improve the comfort and quality of life in selected patients while it may not contribute to surveillance.

Background: The aim of this study was to investigate the effect of Metabolic syndrome (MetS) on the success and complications of percutaneous nephrolithotomy (PNL). Methods: Two hundred ten patients who had undergone PNL for kidney stones in our clinic between May 2012 and May 2014 were retrospectively analyzed. The patients were divided into two groups based on whether they had diagnostic criteria for MetS. All patients had lower pole kidney stones between 15 and 20mm. Complication rates between groups were evaluated using a modified Clavien grading system. Results: Group1 was a standard PNL group and group 2 consisted of patients with MetS. Mean stone size was 293.25102.4mm(2) for group 1 and 301.10 +/- 169.5mm(2) for group 2 (p

To examine the outcomes and to compare the effectiveness of laparoscopic ureterolithotomy and flexible URS in patients with proximal ureteral stones greater than 10 mm in diameter.A total of 150 patients who were performed laparoscopic ureterolithotomy and flexible URS because of uretral stones in our urology clinic between January 2010 and June 2015, were analyzed retrospectively. We constituted two groups; 70 patients who were performed laparoscopic ureterolithotomy were included in group I while flexible URS-performed 80 patients in group II. Success rates and complications of the group I and II were compared.Success rates were 95.7% and 90% in group I and II respectively. There was no significant difference between the groups in terms of "success-rates". No statistically and clinically significant complications occurred in both groups.Laparoscopic ureterolithotomy and flexible URS methods are effective and reliable with proper indications in treatment of proximal ureteral stones. However, when considered short operational and hospitalization times and the management of the situations that require secondary interventions, we suggest that flexible URS is a minimally invasive method and it may be the first choice in the treatment of proximal ureteral stones.

Purpose: Even though vairous surgical procedures are developed to treatment of stress urinary incontinance, there has not been yet a gold standard treatment. In this study, we aimed to discuss the application of TOT technique, its complications, safety and the six year follow up results. Material And Methods: 30 patients applied to our clinic and diagnosed SUI were performed TOT. Mean patient age was 49,9±9,4 (23-64). Demographic parameters, physical and pelvic examination, q tip test, stress test, cystoscopy, ICIQ-SF score, duration of surgery, intraoperative complications, early and late postoperative complications were recorded. Mean follow up was 72,5±7,1 (44-88) months. Patients were evaluated after 1, 3, 6, 12 and 24 months after surgery. Operations were performed by outside-inside method and by using Safyre(promedon). The outcomes were analysed using Shapiro wilk, paired sample t test, Friedman test and Wilcoxon test. Outcomes: Mean operation time and hospital stay were 21,8(15-35) and 1,3 days(1-2) respectively. Peroperatively, one patient(3,3%) had her vaginal wall pierced by the needle. Bladder, uretral or vascular damage were not seen in any patients. Self catheterization was required for only one (3,3%) patient. At late postoperative period, 1 patient developed de novo urge incontinence (3,3%) and one patient developed (3,3%) left leg pain. 73% of the patients with a median follow up of 72,5±7,1 (44-88) months were dry. Preopearative ICIQ-SF median value of 12.4 (8-20) were decreased to 1.7 (0-6), and similarly, ped use was decreased from 2,9 (1-8) to 0,4 (0-3). Results: TOT is a safe and effective treatment of SUI with its long term outcomes. However, long term outcomes with comparison with other techniques and including higher cohorts is required., Amaç: Stres üriner inkontinansın tedavisinde birçok cerrahi yöntem tanımlanmış olmasına rağmen halen bir altın standard yöntem belirlenememiştir. Biz bu çalişmada stres tipte idrar kaçırması olan kadın hastalarda TOT tekniğinin uygulanmasını, komplikasyonlarını, güvenilirliğini ve ortalama altı yıllık sonuçlarını ortaya koymayı amaçladık. Gereç ve Yöntem: Temmuz 2004 ve Şubat 2006 tarihleri arasında kliniğimize başvuran, STİK tanısı konan 30 hastaya TOT uygulandı. Ortalama hasta yaşı 49,9±9,4 (23-64) idi. Demografik özellikler, fizik ve pelvik muayene, q tip testi, stres test, sistoskopi, ICIQ-SF skoru, cerrahinin süresi, intraoperatif komplikasyonlar, erken postoperatif ve geç postoperatif komplikasyonlar kaydedildi. Ortalama takip süresi 72,5±7,1 ay (44-88) idi. Hastalar operasyonun 1.ayında, 3., 6., 12. ayında ve yıllık olarak tekrar değerlendirildi. Operasyon dıştan-içe yöntemle ve materyal olarak Safyre (promedon) kullanılarak uygulandı. Sonuçlar Shapiro Wilk testi, Bağımlı t testi, Friedman testi ve Wilcoxon İşaret testi kullanılarak analiz edildi. Bulgular: Ortalama operasyon süresi 21,8 dakika (15-35) ve ortalama hastanede kalış süresi 1,3 gün (1-2) olarak belirlendi. Peroperatif olarak 1 hastada (%3,3) iğne ile vajen lateral duvarından geçildi. Hastaların hiçbirinde mesane ya da üretral yaralanma veya vasküler hasara bağlı istenmeyen etkiler gözlenmedi. Postoperatif erken dönemde geçici temiz aralıklı kateterizasyon sadece 1 hastada (%3,3) gerekli oldu. Geç postoperatif dönemde ise 1 hastada (%3.3) denova urge inkontinans ve 1 hastada (%3,3) sol bacak ağrısı izlendi. Ortalama izlem süresi 72,5±7,1 ay (44-88) olan hastaların izlem aylarına göre değişmekle birlikte %90-%73 oranında hiç idrar kaçırmadığı belirlendi. Ameliyat öncesi 12,4 (8-20) olan ICIQ-SF skor ortalama değeri 1,68 (0-5)" e, yine ameliyat öncesi sayı olarak 2,9 (1-8) olan ped kullanımı 0,42 (0-3)"ye indi. Sonuç: TOT uzun dönem sonuçları ile STİK tedavisinde etkili ve güvenilir bir tedavi yöntemidir. Ancak uzun dönem sonuçlarını bildiren ve diğer yöntemlerle karşılaştıran geniş poülasyonları içeren randomize prospektif çalışmalara ihtiyaç vardır.

Purpose We aimed to compare the outcomes of pneumatic (PL), ultrasonic (UL) and combined (PL/UL) lithotripsy performed in percutaneous lithotripsy (PNL) according to success rates and stone clearence. Materials and Methods The medical records of 512 patients treated with PNL between April 2010 and April 2013 were evaluated. Postoperative stone analysis revealed as calcium oxalate in 408 of these patients. The operation notes of 355 patients recorded in detail with complete parameters were reviewed. According to stone disintegration method, patients were divided into three groups: PL only in Group I, UL only in Group II, and UL/PL combination in Group III. Number of patients was 155, 110 and 90, respectively. Results Fluoroscopy screening time was significantly shorter in group II, and III compared to group I (p

Purpose To evaluate the long term efficacy and safety of the use of propiverine and terazosine combination in patients with LUTS and DO by a placebo controlled study. Materials and Methods One hundred patients were enrolled in the study. They were randomized into two groups (each group consisted of 50 patients). Terazosine and placebo were administered to the patients in Group 1 and terazosine plus propiverine HCL was administered to Group 2. The patients were evaluated by international prostate symptom score (IPSS), the first four questions of IPSS (IPSS4), the 8th question of IPSS (quality of life-QoL), overactive bladder symptom score questionnaire (OAB-q V8), PSA test, urodynamic studies, post voiding residue (PVR). All patients were followed for one year and were reassessed for comparison. Results IPSS, IPSS4, OAB symptoms, QoL score, PVR, and Qmax scores of the groups did not differ. After one year treatment, there was significant improvement in IPSS, IPSS4, OAB symptoms, QoL and Qmax values in Group 2. No significant improvement was noted for the same parameters in Group 1. Conclusion This is the first study to show long term safety and efficacy of anticholinergic therapy for patients with LUTS. In patients with OAB or DO, long term anticholinergic treatment may be regarded as a treatment option.

It has been shown on experimental rat models that type 5-phosphodiesterase isoenzyme (PDE5) inhibitors have anti-fibrotic effects for Peyronie’s disease (PD); however, this issue has not been addressed clinically. The aim of this study was to document the effects of PDE5 inhibitors used for erectile dysfunction (ED) seen in PD patients on the main course of the PD clinically. A total of 39 PD patients with ED were divided into two groups. Patients in Group 1 (n = 18) served as controls and received 400 IU vitamin E per day. Those in Group 2 (n = 21) received 50 mg sildenafil per day for 12 weeks. Penile plaque volume was assessed by palpation and by duplex ultrasound. Erectile capacity, penile deformity and plaque characteristics were assessed by the International Index of Erectile Function questionnaire form (IIEF-5) and penile duplex ultrasound. Statistically significant improvement in all parameters was observed within both groups except for IIEF score in Group 1 when compared with the initial values. Significant reduction in plaques and pain were observed in 7 (33.3 %) and 14 (66.6 %) patients in Group 2 and 6 (33.3 %) and 9 patients (42.8 %) in Group 1, respectively. At the end of the therapy, improvement in IIEF score and reduction in pain were statistically significant in Group 2 compared with Group 1 (p = 0.028 and p = 0.045, respectively). We conclude that continuous administration of oral PDE5 inhibitors may be a candidate for medical treatment of PD; however, more controlled studies are needed.

Objective: To evaluate the vascular complications of percutaneous nephrolithotomy (PCNL) patients who have undergone previous open surgery, PCNL and extracorporeal shock wave lithotripsy (ESWL). Patients and Methods: 360 patients who underwent a PCNL procedure were included into the study. The patients were divided into 4 groups: group 1: primary PCNL (n = 232); group 2: previous open nephrolithotomy (n = 42); group 3: previous PCNL (n = 33); group 4: previous ESWL (n = 63). The periods of operation and fluoroscopy use of the groups were compared in terms of residual stones, with haematuria, pre-operation and post-operation first-day haemoglobin values. Patients with persistent haematuria were assessed through ultrasonography (US), Doppler US, computed tomography and angiography. Results: Upon comparison of the patients' pre- and post-operative haemoglobin changes, haemoglobin was statistically higher in the previous open operation group than the others (p = 0.02). Permanent and intermittent haematuria were detected in 12 (3%) and 7 patients (1%), respectively. Angiography was done in 7 (1.94%) patients. This rate was 9.5% for group 2 and 3% for group 3. These rates were found to be statistically higher than compared to the other groups. Arteriovenous fistula (AVF) was detected in 4 of these patients and pseudoaneurysm in 1. While 1 of the patients with AVF improved spontaneously, embolisation was applied to 4 patients. Four of the patients had had a previous open operation, while 1 had had a PCNL treatment. Conclusions: Vascular complication is a rare complication of PCNL that can be successfully managed with angioembolisation. Our results indicate that previous open surgery significantly predicted the occurrence of these lesions.

Objective: To assess the effectiveness of trans obturator tape (TOT) for the surgical treatment of stress urinary incontinance (SUI) on female sexuel function. Methods: We evaluated 34 sexualy active patients, who had stress urinary incontinance. Patients sexuel function evaluated preoperative and 6 months after operation with Female Sexuel Function Index (FSFI) scores. Results: Statistically significant improvements were seen in daily pad use from 2.4±1.1 to 0.2±0.4 (p value

Objective: To present the long-term results of hydrophilic dilatation catheter or steroid-coated hydrophilic dilatation catheter usage in the management of primary urethral stricture. Methods: Forty-one male patients with a diagnosis of primary urethral stricture shorter than 1.5 cm and no comorbities were included in this study. After application of internal uretrotomy, these patients were randomized into two groups. A steroid-coated (triamcinolone acetonide (1%) 18F hydrophilic dilatation catheter was applied to the patients in group 1 for 2 weeks and an 18F hydrophilic dilatation catheter was applied to the patients in group 2 for 2 weeks, and catheters were removed after 3 days. Uroflowmetry and recurrence rate was used in postoperative follow-ups. Results: Mean patient age were respectively 45.1±8.0 and 47±8.8(68-29) years. Urethral stricture length was evaluated for group 1 7.4±4.0 mm and group 2 7.8±4.3 mm p:0.79. All patients uroflowmetry value (Q max) were followed up on 6,12,24 and 36 month and results were evaluated. Recurrence of urethral stricture was determined in 3 (13%) patients in group 1, and 3 (15%) patients in group 2 (p

Background: We aimed to evaluate the efficacy of two mostly used intravesical agents, bacillus Calmette-Guerin (BCG) and mitomycin C (MMC), for tumor recurrence in non-muscle invasive bladder cancer. Methods: Between January 2002 and April 2008, we performed TUR-BT on 127 patients whose pathology results were superficial bladder cancer. Patient files are examined retrospectively. Forty-one patients were treated with intravesical BCG once a week for 6 weeks, and then monthly up to 1 year from 14th day postoperatively. Twenty-six patients were treated with intravesical MMC, from first 6 h postoperatively and once a week for 8 weeks. Results: There was no statistically significant difference between groups for age, gender, number of tumors, tumor size, and pathological staging (P = 0.354, P = 0.315, P = 0.457, P = 0.302, and P = 0.692, respectively). In BCG group, 13 (31.7%) patients recurred. For MMC group, recurrence was seen in 9 (34.6%) patients. One and three years disease free survival rates were 92.7% and 75.7% in BCG group, and 76.9% and 62.9% in MMC group. In BCG group, estimated recurrence-free survival was 58.1 months, and it was 34.6 months for MMC group. Estimation difference among groups was statistically significant (P = 0.017). Conclusions: Intravesical adjuvant BCG maintenance therapy is more effective for tumor recurrence than intravesical MMC therapy. World J Nephrol Urol. 2013;2(2):65-69 doi: http://dx.doi.org/10.4021/wjnu128e

We aimed to investigate the impact of metabolic syndrome (MetS) on the varicocele treatment. 101 patients underwent spermatic vein ligation between 2007 and 2010 were retrospectively analyzed. Those patients were divided into two groups as without (n: 56, Group 1) or with MetS (n: 48, Group 2). All the patients underwent left microsurgical subinguinal spermatic vein ligation. Groups were compared by the improvement on sperm parameters and spontaneous pregnancy rates at a mean of 19 (±4) months followup. When sperm parameters were compared postoperatively, the significant improvement in total sperm count, motile sperm count percentage, and normal sperm percentage was reported. The groups were compared to each other and the improvement seemed significantly better in Group 1. There was no statistically significant improvement difference in the normal sperm percentage between groups. Spontaneous pregnancy rate after two years was 45% in Group 1 and 34% in Group 2 (). Patients with MetS and varicocele improved after surgery, but not as well as the similar group without MetS. This may help to show that MetS can be a factor for male infertility.