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Objective: We aimed to describe the outcomes and patient satisfaction (PS) rates of transurethral polyacrylamide hydrogel (PAHG) (Bulkamid®) injection for the treatment of female stress urinary incontinence (SUI) in a Turkish cohort. Materials and Methods: Twenty-two patients who underwent injection primarily or secondarily between December 2019 and March 2023 due to SUI or stress-predominant mixed urinary incontinence (MUI) were retrospectively evaluated. All patients underwent an invasive urodynamic study (UDS) before the procedure. The primary outcome was treatment success (TS), defined as no pad use, negative International Continence Society (ICS) uniform cough stress test (CST), and no SUI on International Consultation on Incontinence Questionnaire-Short Form question 6. The secondary outcome was PS. Results: The median age was 61.5 (41-84) years. Six patients had stress-predominant MUI and 15 had SUI. PAHG injection was the primary and secondary treatment in 17 and 4 patients, respectively. ICS uniform CST was positive in all patients. In 8 patients, intrinsic sphincter deficiency (ISD) was detected during UDS. One patient developed transient urinary retention after surgery. At a median follow-up of 17 (1-38) months, the overall TS rate was 85.7%. Success rates in primary vs. secondary setting and pure SUI vs. MUI were 88.2% vs. 75% and 80% vs. 100%, respectively. The overall PS rate was 90%. Satisfaction rates in the primary vs. secondary setting and pure SUI vs. MUI were 93.6% vs. 75% and 85.7% vs. 100%, respectively. TS and PS rates were 100% in all patients with ISD. Conclusion: PAHG injection proved to be a safe and effective minimally invasive treatment for pure stress and stress-predominant MUI in both primary and secondary settings.

Purpose: Our study aims to compare speech understanding in noise and spectral- temporal resolution skills with regard to the degree of hearing loss, age, hearing aid use experience and gender of hearing aid users. Methods: Our study included sixty-eight hearing aid users aged between 40-70 years, with bilateral mild and moderate symmetrical sensorineural hearing loss. Random gap detection test, Turkish matrix test and spectral-temporally modulated ripple test were implemented on the participants with bilateral hearing aids. The test results acquired were compared statistically according to different variables and the correlations were examined. Results: No statistically significant differences were observed for speech-in-noise recognition, spectral-temporal resolution among older and younger adults in hearing aid users (p>0.05). There wasn’t found a statistically significant difference among test outcomes as regards different hearing loss degrees (p>0.05). Higher performances were obtained in terms of temporal resolution in male participants and participants with more hearing aid use experience (p

Objective: This study aimed to assess the urethrovesical anastomotic leakage (UAL) and associated factors in patients who underwent robot-assisted radical prostatectomy (RARP) and its effect on early continence. Material and Methods: The data of 81 patients who underwent RARP between February 2017 and June 2022 were evaluated in this retrospective analysis. On the seventh postoperative day, we performed a cystography to determine whether the patients had UAL. Uni- and multivariate analyses were done to investigate the factors that could lead to UAL. Continence rates were recorded in patients at 6-12 weeks after surgery. Results: Overall 25 patients (31%) had UAL; of them 12 (15%) were mild, eight (10%) were moderate, and five (6%) were extensive. A drain/ serum creatinine ratio >1.5 and a prostate volume >53 cm3 were determined to be significant in predicting UAL in both the uni- and multivariate analyses (p=0.017 and p=0.046, respectively). On the postoperative second or third day, of the 36 patients who had drain output greater than 100 ml, eight (22%) had a high drain/serum creatinine ratio (>1.5), seven (88%) of which had UAL. According to the early period follow-up data, incontinence was prevalent in 9 (36%) of the patients with UAL and 20 (%37) of the patients without UAL (p=0.959). Conclusion: Cystography is an effective method for detecting leakage after RARP. A large prostate volume (>53 cm3) and a high postoperative drain/serum creatinine ratio (>1.5) were found to be associated with UAL. UAL had no effect on early continence. Keywords: anastomotic leak, cystography, prostatectomy, robot-assisted, urinary incontinence

Objective:To evaluate the impact of coronavirus disease-2019 (COVID-19) lockdown on the sexual lives of couples who live in Turkiye.Materials and Methods:One hundred ninety-three sexually active participants. While sexual functions were evaluated with the international erectile function index-15 in men and the female sexual function index in women, Hamilton anxiety scale (HAM) was used to measure anxiety level. Married people filled out the Marriage adjustment test (MAT) questionnaire. The effects of the quarantine period on the relationship were evaluated with a questionnaire created specifically for this study.Results:Sexual improvement and worsening were observed in 8.8%, and 15%, respectively. It did not change for 76.2%. Sexually deteriorated subjects had a higher HAM score (p=0.003). The MAT score was lower in sexually deteriorated subjects (p=0.004). The rate of sexual worsening was higher in women than in men (28.6% vs. 12%, p=0.02). Women’s HAM scores were higher (p=0.002). The MAT score was also found to be higher in women (p=0.0037). 58% of sexually deteriorated participants did not feel safe at home during the COVID-19 period, whereas all of those sexually improved participants felt safe at home.Conclusion:During the COVID-19 lockdown period, sexual deterioration was detected in 15% of sexually active people. This worsening was associated with the HAM score. Additionally, it was revealed that feeling safe at home is related to sexual life. While the relationship between sexually worsening and the MAT score was significant in men, it was revealed that the level of anxiety in women affected sexual life more significantly.

Objective: The advantages of robot-assisted surgery include shorter incisions, less postoperative pain, perioperative blood loss, and a faster return to daily functions. Thoracic epidural analgesia (TEA) provides highly satisfactory analgesia in abdominal surgery. However, its hypotensive effect, particularly in minimally invasive procedures, exceeds its contribution to rapid recovery. Fascial plane blocks may be more beneficial in that context. This study evaluated the effects of regional analgesia techniques in robotic prostatectomy, nephrectomy, and cystectomy operations. Material and Methods: Following IRB Ethics Committee approval (2021.467.IRB1.134), the records of patients who had undergone robotic prostatectomy, nephrectomy, and cystectomy surgeries were retrospectively reviewed between January 2018 and January 2022. Results: One hundred and forty patients with full documentation were included in this study. Various regional analgesia methods were used. Fascial plane blocks were seen to be used in addition to epidural analgesia. Transversus abdominis plane (TAP) and rectus sheath blocks exhibited satisfactory results in robotic prostate surgeries and TAP blocks in robotic nephrectomy operations. Conclusion: In robotic prostatectomy and nephrectomy operations, we recommend fascial plane blocks as the first-choice method for postoperative analgesia. Keywords: regional anesthesia, robotic surgery, radical prostatectomy, minimally invasive surgery, fascial plane blocks, recovery after surgery

Objective:: Urinary retention after non-urological surgery is a common morbidity, yet its​ etiology and treatment approaches are still a matter of debate. The primary aims of this study are to evaluate the management of urinary retention after non-urological surgeries, determine the predictors of prognosis, and report follow-up data. Methods:: Patients who were referred to the urology clinic at a single center due to postoperative urinary retention between December 2014 and November 2021 were included. Demographical, clinical, and surgical parameters were recorded. In all patients, a urethral catheter was kept in-situ for at least 5 days after urinary retention. In case of persistent urinary retention after catheter removal, clean intermittent catheterization (CIC) was recommended. Results of the patients who spontaneously regained micturition after conservative treatment and those with persistent urinary retention were compared. Results:: Among 95 patients, the median age was 65 (24–90) years. In 75 patients (78.9%), spontaneous micturition returned with conservative management (Group 1). Twenty patients (21.1%) required CIC due to persistent urinary retention (Group 2). The percentages of males in Group 1 and 2 were 81.3% and 50% respectively (p

Abstract This study aimed to enhance the accuracy of Gleason grade group (GG) upgrade prediction in prostate cancer (PCa) patients who underwent MRI-guided in-bore biopsy (MRGB) and radical prostatectomy (RP) through a combined analysis of prebiopsy and MRGB clinical data. A retrospective analysis of 95 patients with prostate cancer diagnosed by MRGB was conducted where all patients had undergone RP. Among the patients, 64.2% had consistent GG results between in-bore biopsies and RP, whereas 28.4% had upgraded and 7.4% had downgraded results. GG1 biopsy results, lower biopsy core count, and fewer positive cores were correlated with upgrades in the entire patient group. In patients with $$\hbox {GG}>1$$ GG > 1 , larger tumor sizes and fewer biopsy cores were associated with upgrades. By integrating MRGB data with prebiopsy clinical data, machine learning (ML) models achieved 85.6% accuracy in predicting upgrades, surpassing the 64.2% baseline from MRGB alone. ML analysis also highlighted the value of the minimum apparent diffusion coefficient ( $$\hbox {ADC}_{\text{min}}$$ ADC min ) for $$\hbox {GG}>1$$ GG > 1 patients. Incorporation of MRGB results with tumor size, $$\hbox {ADC}_{\text{min}}$$ ADC min value, number of biopsy cores, positive core count, and Gleason grade can be useful to predict GG upgrade at final pathology and guide patient selection for active surveillance.

Objective: Although laparoscopic partial nephrectomy (LPN) is minimally invasive, it is also a technically challenging procedure. Currently, open partial nephrectomy (OPN) remains the only alternative in many centers for T1 kidney tumors. We reported our initial experience of LPN compared to OPN regarding clinical, oncological findings and renal functions . Material and Methods: Between 2004-2013, 81 patients who underwent OPN (n=55) or LPN (n=26) for clinically T1 renal tumors were included. Perioperative and postoperative data were compared, retrospectively. Follow-up times for OPN and LPN groups were 72.9± 41.1 and 47.6± 32.4 months, respectively (p

In the past few years, automatically generating descriptions for images has attracted a lot of attention in computer vision and natural language processing research. Among the existing approaches, data‐driven methods have been proven to be highly effective. These methods compare the given image against a large set of training images to determine a set of relevant images, then generate a description using the associated captions. In this study, the authors propose to integrate an object‐based semantic image representation into a deep features‐based retrieval framework to select the relevant images. Moreover, they present a novel phrase selection paradigm and a sentence generation model which depends on a joint analysis of salient regions in the input and retrieved images within a clustering framework. The authors demonstrate the effectiveness of their proposed approach on Flickr8K and Flickr30K benchmark datasets and show that their model gives highly competitive results compared with the state‐of‐the‐art models.

PURPOSE: To evaluate hyoscine N-butyl bromide (HBB) and three different alpha-1 blockers in the treatment of distal ureteral stones. MATERIALS AND METHODS: A total of 140 patients with stones located in the distal tract of the ureter with stone diameters of 5 to 10mm were enrolled in the present study and were randomized into 4 equal groups. Group 1 received HBB, Group 2 received alfuzosin, Group 3 received doxazosin and Group 4 received terazosin. The subjects were prescribed diclofenac injection (75 mg) intramuscularly on demand for pain relief and were followed-up after two weeks with x-rays of the kidneys, ureters, bladder and urinary ultrasonography every week. The number of pain episodes, analgesic dosage and the number of days of spontaneous passage of the calculi through the ureter were also recorded. RESULTS: The average stone size for groups 1, 2, 3 and 4 was comparable (6.13, 5.83, 5.59 and 5.48 mm respectively). Stone expulsion was observed in 11%, 52.9%, 62%, and 46% in groups 1, 2, 3 and 4 respectively. The average time to expulsion was 10.55 ± 6.21 days in group 1, 7.38 ± 5.55 days in group 2, 7.85 ± 5.11 days in group 3 and 7.45 ± 5.32 days in group 4. Alpha blockers were found to be superior to HBB (p < 0.05). CONCLUSIONS: Medical treatment of distal ureteral calculi with alfuzosin, doxazosin and terazosin resulted in a signi?cantly increased stone-expulsion rate and decreased expulsion time when compared with HBB. HBB seems to have a negative effect on stone-expulsion rate.