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Non-choriocarcinomatous trophoblastic tumors (NCTTs) are seldomly diagnosed in male genital tract. As they have been recently described among the testicular germ cell tumor (TGCT) variants, pathologists' familiarity with their morphology is limited. We searched our electronic hospital records covering the years 2000-2017 for post-chemotherapy retroperitoneal TGCT metastectomies. Slides of all cases with viable tumor were retrieved from the archives and reviewed. Cases suspected of N-CTT morphologies were subjected to immunohistochemistry. Twelve NCTTs were identified, 9 of which were unseen or misdiagnosed by the original pathologists: Cystic trophoblastic tumor (CTT) (n = 5), placental site trophoblastic tumor (n = 2), epithelioid trophoblastic tumor (ETT) (n = 4), and coinciding PSTT + ETT (n = 1). Eight of these were associated with mature teratoma components, and one case (ETT) contained embryonal carcinoma and yolk sac tumor in addition to teratoma. Ten patients were clinically N1 at the time of primary tumor detection and orchiectomy. One patient had burned-out primary testicular tumor. Six patients were clinical M1a at presentation, while one male was cM1b. Six patients had mildly elevated β-HCG (≤ 410 mIU/ml) just prior to retroperitoneal lymph node dissections (RPLND), while the others had normal β-HCG levels. All patients had follow-ups ranging from 8 to 118 months (mean 42.3 months). Three patients died of disease-related and two of unrelated causes. In conclusion, because NCTTs are rare and newly described tumor types, their diagnosis is difficult and most of them are missed in post-chemotherapy RPLNDs. The majority of patients exhibit normal or slightly elevated β-HCG levels. N-CTTs are usually accompanied by other components of TGCT, the most common being teratoma. Despite the high survival rate of the patients, our study points to the unpredictable evolution of NCTT cases, which may concur with a high-stage or progressive disease.

To determine the factors that cause erectile dysfunction and penile curvature after repair of penile fracture (PF).Data from 25 patients who underwent PF repair was retrospectively analyzed. PF was diagnosed by examining patients' medical histories and performing physical examinations. All patients underwent immediate PF repair. All patients filled out the International Index of Erectile Function (IIEF-5) form and penile curvature was examined.The median age of patients at the time of surgery and the median follow-up duration were 46 years (22-60 years) and 95 months (12-156 months), respectively. Two of the patients had concomitant urethral injury. At the final follow up, erectile dysfunction (ED) was present in 13 patients (52%). Among these patients, 9 patients (36%) had mild ED and 4 patients (16%) had moderate ED. With a univariate analysis, age and penile curvature were significantly associated with ED (p=0.008 and p=0.039, respectively). With a multivariate analysis, age was independently associated with ED (p=0.048, odds ratio=1.104, 95% confidence interval 1.000-1.218). The IIEF-5 scores correlated with age (p=0.009, r=0.510). Seven patients (28%) had penile curvature and one patient underwent penile plication surgery.After PF repair, age is the only risk factor for ED and penile curvature rarely requires surgical treatment.

Objective:To investigate factors affecting the success rate of endoscopic subureteral injection (ESI) in patients with vesicoureteral reflux (VUR) and to evaluate the changes in years.Materials and Methods:A total of 439 patients with primary VUR who underwent ESI were included. We used dextranomer hyaluronic acid co-polymer (Dx-HA) as bulking agent. Statistical analyzes were performed by SPSS 20.0 programme.Results:Overall patient-based and renal unit-based success rates of ESI were 75.6% and 78.2%, respectively. Operational age of 82 months and lower grades of VUR were found to be the factors increasing success rate (p=0.023, p=0.005). Success rates were as 83.6%, 77.9% and 64.5% for grades of reflux 1-2, 3 and 4-5, respectively (p=0.002). When patients were seperated into four equal chronological groups, we observed that the ratio of patients who had previous failed ESI, high-grade reflux and renal scarring and volume of injected material has increased over the years.Conclusion:ESI has higher success rates in older children and lower grades (grades 1-3) of VUR. It is performed also in high-grade patients with acceptable success rates which tended to increase over the years.

Objective To report our experience with ureterolysis for the management of retroperitoneal fibrosis. Methods The data of 25 patients who underwent ureterolysis due to primary retroperitoneal fibrosis between 2002 and 2017 were reviewed retrospectively. Initial symptoms, laterality, renal function status (initial/final), operation complications and serum creatinine levels (diagnosis/preoperative/6 months, 12 months postoperatively) were recorded. After surgery, patients were followed up by ultrasonography and serum creatinine levels. Patients with impaired results underwent furosemide renogram and/or late phase of computed tomography. Factors affecting final serum creatinine levels were evaluated. The χ2 -test was used for nominal data among groups. The level of statistical significance was set as P Results A total of 19 patients (76%) were operated bilaterally. The mean follow-up period was 46.2 ± 9.2 months. Among 44 operated renal units, non-functioning kidney developed in seven (15.9%). A total of 34 renal units (77.3%) did not require any additional surgical intervention, and two underwent balloon dilatation (4.5%), one (2.25%) followed with double J stent changes. Two patients developed end-stage renal disease secondary to bilateral unresolved obstruction. High final serum creatinine levels developed in eight (32%) patients without dialysis. Eight patients (32%) were treated with immunosuppressive therapy for systemic recurrence. There was a significant relationship between preoperative serum creatinine levels with final serum creatinine levels (P = 0.005). There was no statistically significant relationship between diagnosis serum creatinine levels with final serum creatinine levels and postoperative dialysis requirement (P = 0.79 and P = 0.817, respectively). Conclusions Ureterolysis provides acceptable success with low complication rates in patients with retroperitoneal fibrosis. Preoperative high-serum creatinine levels can be considered as a risk factor for long-term renal impairment and these patients should be followed closely.

Aim To assess the power of nephrometry scores to predict the intraoperative conversion from partial nephrectomy (PN) to radical nephrectomy (RN). Methods We identified all the patients at our institution who were scheduled for PN between April 2012 and December 2017. Patients who underwent robotic or laparoscopic surgery were excluded. A total of 149 patients (94 men) who underwent open surgery and had complete data were included. The power of the R.E.N.A.L., PADUA, SPARE, and DAP scores to predict the conversion to RN, and the threshold values were assessed. In the multivariate analysis, the predictive power of the nephrometry scores was tested by separately including them in different models. Results The median age was 57 (48-67) years, while the median follow-up was 15 (7-29.5) months. The overall conversion rate was 10.7%. The optimal cut-off values for the R.E.N.A.L., PADUA, SPARE, and DAP scores were 7.5, 9.5, 5.5 and 7.5, respectively. The SPARE score had the highest area under the curve (AUC = 0.807, P

Introduction A large number of genes and environmental factors, like dietary habits, play a role in the development of hypercalciuria in children. In this study, we aimed to determine the effects of the presence and grade of vesicoureteral reflux (VUR) on hypercalciuria status in children. Materials and Methods Data for 165 patients who admitted to the Pediatric Urology Department were retrospectively analyzed. The patients were composed of following four different groups: (1) urinary stone patients, (2) VUR patients under follow-up, (3) corrected VUR patients, and (4) control. The demographic features, clinical data, and laboratory tests for the groups were compared. Results The mean age of the patients was 100.6 ± 54.69 months and the female/male ratio was 79:86. The mean urinary calcium/creatinine (UCa/Cr) excretion and the frequency of high UCa/Cr ratios in the corrected VUR group were similar to those in the control group (p = 0.375 and 0.965, respectively). In contrast, the mean UCa/Cr excretion and frequency of high UCa/Cr ratios in the urinary stone and follow-up VUR groups were significantly higher than those in the corrected VUR group (p Conclusion Both the mean UCa/Cr ratio and the rate of hypercalciuria in the corrected reflux group were significantly lower than the corresponding values in the follow-up VUR and urinary stone groups. Further, the follow-up VUR patients had similar urinary calcium excretion levels as the stone patients. VUR treatment is associated with a decrease in urinary calcium excretion to the normal population level. A positive correlation between reflux degree and calcium excretion was observed.

Objective: To determine the factors affecting the outcomes of percutaneous nephrolithotomy (PCNL) in patients in infantile/toddler and preschool age group. Materials and Methods: The data of 186 re...

Objective:To reveal the significance of core length in current primary transrectal ultrasound-guided prostate biopsy (TRUS-PB) in patients with normal digital rectal examination.Materials and Methods:Data of 3520 patients, who received TRUS-PB between March 2002 and April 2015, were reviewed retrospectively. A total of 1627 primary biopsy patients with a normal digital examination and with no lesion in TRUS were included in the study. The mean core length was found by dividing the sum of the total core lengths by the core number. The relationships of cancer detection rate (CDR) with age, Prostate-specific antigen (PSA) value, prostate volume, number of cores (10 or 12 cores) and mean core length were investigated.Results:The mean patient age, PSA and prostate volume were 62.3±7.9 years, 9.1±7.8 ng/mL and 55.8±21 mL, respectively. Cancer was diagnosed in 394 patients (24.2%). The mean core length was 12.7±1.7 (4.3-21.5) mm. Ten- and 12- core biopsies were performed in 1068 (65.6%), and 559 (34.4%) patients, respectively. Older age, PSA, mean core length, number of cores and reduced prostate volume were found to be associated with CDR (p

The authors aimed to evaluate the factors affecting clinical outcomes of cystine stone disease in children and to understand the change in disease management over time. Between January 1991 and September 2017, the demographic and clinical data of pediatric patients with documented cystine stone disease were retrospectively analyzed. Patients with at least 12-month follow-up were included. Disease management and clinical outcomes were compared between the first and second 35 patients managed during the study's time frame. A total of 70 patients were included. The female to male ratio was 30/40. The mean age and follow-up period was 29.8 ± 40.1 months and 106.5 ± 56 months, respectively. The mean initial procedure number to treat the first stone episode was 2.4 ± 1.6. Single stone and single affected site were significant predictors for stone clearance. Overall, patients underwent a mean of 5.5 procedure during their follow-up. Recurrence was detected in 71.4% (50/70) of patients. Residual fragments and non-compliance to medical treatment after the initial intervention were significant predictors for recurrence within shorter interval period. 31.4% (22/70) of patients had renal atrophy during follow-up. They were older at the initial diagnosis and had average urine pH lower than 7.5. The first 35 patients had more open procedures. Still, they had more recurrence rate and tend to have more renal atrophy. As a conclusion, cystine stone disease has a recurrent course in children. Stone and fragments entirely removed (SaFER) concept with all minimally invasive methods available and strict follow-up should be the basis for any management plan.

Objective:The magnification of the operative microscope or loop used in microsurgical varicocelectomy facilitates defining the anatomical structures. Even if the microsurgical approach is chosen, still, there is a 1% chance of iatrogenic testicular artery ligation and this may lead to the testicular atrophy. In this study, our aim was to present the efficacy and safety of the micro-Doppler ultrasound (USG) used during microsurgical varicocelectomy for the first time in Turkiye.Materials and Methods:A total of 46 patients with clinical varicocele underwent microsurgical varicocelectomy from May 2018 to July 2019. The da Vinci surgical system (CordaMed, İstanbul) was used in 5 patients and a standard operating microscope was used in 41 patients. Once the spermatic cord was brought up during the surgery, the velocity time integral microvascular Doppler system (Deltamed, Ankara) was used to identify the testicular vessels. The micro-Doppler USG probe allowed differentiation of the vessel by hearing the arterial pulsation audio.Results:Microsurgical varicocelectomy was performed in 46 patients and 48 spermatic cord units. The mean number of spermatic veins that were ligated in each spermatic cord unit was 3.05 (2-5) and each spermatic cord unit had mean 1.4 (1-3) spermatic arteries that were preserved. The mean follow-up duration was 9 months and none of the patients developed testicular atrophy after the procedure.Conclusion:The use of micro-Doppler USG in micro-surgical varicocelectomy seems to be an effective and safe method that facilitates the identification of testicular vessels. With the aid of micro-Doppler USG, even very small size arteries could be easily identified and iatrogenic damage could be avoided.

To find if there is any potential benefit of serum Sphingosine-1-Phosphate (S1P) level in the diagnosis of Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC). Patients newly or previously diagnosed with BPS/IC between September 2017 and December 2018 were included. Healthy individuals who volunteered to enter the study were included as control group. The measurements of serum S1P in both groups were compared. Multiple regression analysis was conducted to find out the significant factors affecting S1P results. A total of 47 BPS/IC patients and 47 healthy controls were included. BPS/IC patients were older than controls (48.5 ± 12.4 vs 38.9 ± 8.1 years, p

Using data compression algorithms in data transmission and storage provides advantages in terms of time and storage cost. There are several methods for compressing texts created in natural language which is one of the most produced data types. Many traditional methods are not successful in compressing short texts. Compressing short texts requires different methods than general-purpose compression methods. In this study, a short text compression algorithm which uses the prediction mechanism of BERT is proposed and compared with traditional methods. In addition, the results of the proposed method were examined and compared for different parameters and models. The proposed method has achieved compression ratios up to 39% better than traditional algorithms such as Gzip, Bzip2 and Zstd., Veri aktarımı ve saklanmasında veri sıkıştırma algoritmalarının kullanılması, aktarım süresi ve saklama maliyeti açısından avantaj sağlamaktadır. En çok üretilen veri türlerinden biri olan doğal dildeki metinlerin sıkıştırılması için farklı yöntemler bulunmaktadır. Geleneksel birçok yöntem kısa metinlerin sıkıştırılmasında başarı gösterememektedir. Kısa metinlerin sıkıştırılması için genel amaçlı sıkıştırma yöntemlerinden daha farklı yöntemlere ihtiyaç duyulmaktadır. Bu çalışmada BERT’in tahmin mekanizmasını kullanan bir kısa metin sıkıştırma algoritması önerilmiş ve geleneksel yöntemler ile karşılaştırılmıştır. Ayrıca önerilen yöntemin başarısı farklı parametreler ve modeller için incelenmiş ve karşılaştırılmıştır. Önerilen yöntem Gzip, Bzip2 ve Zstd gibi bilinen algoritmalara göre %39’a kadar daha başarılı sıkıştırma oranları elde etmiştir.

Purpose To evaluate the long-term outcomes of autoaugmentation (AA) in pediatric population. Materials and Methods The data of 59 patients (32 females and 27 males) who underwent AA between 1993 and 2018 were analyzed retrospectively. During postoperative follow-up, deterioration on renal scan and/or nonimproved hydronephrosis (HN) were described as upper urinary tract (UUT) impairment. Incontinence was described as use of diaper or pad. Preoperative urodynamic volume was divided into two as less than 50 and more than or equal to 50% expected bladder capacity (EBC). The effect of preoperative clinical factors on reaugmentation, incontinence, and UUT impairment was evaluated. Results The mean age and the median follow-up were 8.9 ± 3.6 years and 64 (12–218) months, respectively. Ten (16.9%) patients underwent reaugmentation (ureteral or ileal). UUT impairment and incontinence rates were 13.6% (8/59) and 30.5% (18/59), respectively. On multivariate analysis, less than 50% EBC was the only predictor of reaugmentation and incontinence (p = 0.013, odds ratio [OR]: 17.546 and p = 0.035, OR: 3.750, respectively). Preoperative HN was predictor of UUT impairment (p = 0.041, OR: 10.168). After AA, 51 patients used clean intermittent catheter and 27 (45.8%) patients discontinued the use of anticholinergic medication. At follow-up, eight (13.5%) patients underwent surgery after AA due to long-term complications, dissatisfaction, or poor functional results (bladder neck injection, cystolithotripsy, Mitrofanoff revision, dilatation, and injection). Conclusion AA is a viable option in selected cases with high pressure and low compliant bladders. Preoperative bladder capacity is significant for reaugmentation rate and continence. UUT impairment is related to preoperative HN.

In this study, a classification process for language recognition has been performed on two data sets of different sizes consisting of Wikipedia article abstracts. Dataset group A consists of article abstracts of 204 bytes and less, while dataset group B consists of abstracts of between 204 and 512 bytes. The first goal of the study is to determine the appropriate machine learning and attribute selection method according to the sizes of the short texts. The second goal is to determine the fastest and most accurate classification method. As a result of the tests performed; the highest accuracy value has been achieved by using SelectFromModel-Logistic Regression in atributee selection, while as a machine learning method, Naive Bayes Multinominal and Naive Bayes Bernoilli have been superior to each other according to data sets of different lengths. In addition, as a result of the tests performed with all classification methods used in the study, it has been understood that fasttext is superior in terms of accuracy and WBSM in terms of speed in both data sets compared to other classification methods., Bu çalışmada Wikipedia makale özetlerinden oluşan farklı boyutlardaki iki veri seti üzerinde dil tanımaya yönelik sınıflandırma işlemi yapılmıştır. A veri seti grubu 204 bayt ve daha kısa makale özetlerinden oluşurken, B veri seti grubu 204 ile 512 bayt arasındaki özetlerden oluşmaktadır. Çalışmadaki birinci hedef kısa metinlerin boyutlarına göre uygun makine öğrenmesi ve öznitelik seçme yönteminin belirlenmesidir. İkinci hedef ise en hızlı ve yüksek doğrulukla sınıflandırma yapan yöntemin tespit edilmesidir. Yapılan testler sonucunda öznitelik seçiminde SelectFromModel-Lojistik Regresyon kullanılması ile en yüksek doğruluk değerine ulaşılırken, makine öğrenmesi yöntemi olarak Naive Bayes Multinominal ve Naive Bayes Bernoilli farklı uzunluktaki veri setlerine göre birbirlerine üstünlük sağlamaktadır. Ayrıca çalışmada kullanılan tüm sınıflandırma yöntemleri ile yapılan testler sonucunda, her iki veri setinde diğer sınıflandırma yöntemlerine göre fasttext’in doğruluk bakımından, KTİY’nin ise hız bakımından üstünlük sağladığı anlaşılmıştır

The objective of the study was to determine the effect of variant histology on pathological outcomes and survival in patients operated for the upper urinary tract urothelial carcinoma (UTUC).Data of 128 patients who were operated for UTUC between 2001 and 2019 were retrospectively analyzed. Patients with pure urothelial carcinoma and patients with variant histology were compared in terms of demographics, pathological outcomes, and survival.The mean age of the patients was 65±11 years, female to male ratio was 30/98 and median follow-up period was 26.5 (1-176) months. Variant histology was detected in 14.8% of patients. Variant histology was found to be associated with surgical margin positivity, lymph node metastasis, presence of lymphovascular invasion, high tumor stage and grade (p=0.001, p=0.012, p=0.001, p=0.002, and p=0.009, respectively). Three-year cancer-specific and overall survival rates were 79.6% and 77.3%, respectively. There was no statistically significant relationship between variant histology with cancer-specific and overall survival (p=0.514 and p=0.515, respectively).Variant histology of UTUC was found to be associated with locally advanced disease, but its effect on survival could not be demonstrated.

In this study, an alternative method that can be used to measure clustering performance is proposed. In order to test the consistency of the proposed method, two different data sets consisting of Wikipedia abstracts were clustered with k-Means, k-Medoids and CLARANS methods and performance measurements were calculated with both the proposed method and the existing methods. The first data set containing only English summaries was tested by dividing it into different numbers of clusters. Since there was no prior knowledge of the content of the abstracts, the internal methods Silhouette, Calinski-Harabasz, and Davies-Bouldin were used to evaluate how accurately they were clustered. The second data set, which includes Wikipedia abstracts of 6 different languages, is divided into 6 clusters with clustering methods to classify the abstracts according to their language. Since the language of the summaries in the data set is known beforehand, the success of clustering could be measured by both internal and external methods. Since it is known that data compression algorithms compress a file with similar texts better than a file with different texts, it has been suggested that compression ratio can be used as an alternative evaluation metric. The proposed Compression Ratio Index (CRI), which can be calculated much faster than internal methods such as Silhouette, Calinski-Harabasz and Davies-Bouldin indexes, was tested with 4 different compression algorithms and yielded the same results with 9 external methods used in the second data set., Bu çalışmada kümeleme performansını ölçmek için kullanılabilecek alternatif bir yöntem önerilmiştir. Önerilen yöntemin tutarlılığını test etmek için, Wikipedia makale özetlerinden oluşan iki farklı veri kümesinde k-Means, k-Medoids ve CLARANS yöntemleri ile kümelemeler yapılmış ve hem önerdiğimiz yöntem hem de mevcut yöntemler ile performans ölçümleri hesaplanmıştır. Sadece İngilizce özetlerin olduğu ilk veri kümesi farklı sayıda kümelere ayrılarak test edilmiştir. Özetlerin içeriği hakkında önceden bilgi sahibi olunmadığı için ne kadar doğru kümelendiğini değerlendirmek için dahili yöntemler olan Silhouette, Calinski-Harabasz ve Davies-Bouldin indeksleri kullanılmıştır. 6 farklı dile ait Wikipedia özetlerini içeren ikinci veri kümesi ise özetlerin dillerine göre sınıflanmış olması için kümeleme yöntemleri ile 6 kümeye ayrılmıştır. Veri kümesindeki metinlerin hangi dile ait olduğu önceden bilindiği için kümelemenin başarısı hem dahili hem de harici yöntemler ile ölçülebilmiştir. Veri sıkıştırma algoritmalarının birbirine benzer metinlerin olduğu bir dosyayı, birbirinden farklı metinlerin olduğu dosyaya göre daha iyi sıkıştırdığı bilindiğinden, sıkışma oranının alternatif bir değerlendirme ölçütü olarak kullanılabileceği önerilmiştir. Silhouette, Calinski-Harabasz ve Davies-Bouldin indeksleri gibi dahili yöntemlere göre çok daha hızlı hesaplanabilen önerilen Sıkıştırma Oranı İndeksi (SOİ), 4 farklı sıkıştırma algoritması ile test edilmiş ve ikinci veri kümesinde kullanılan 9 harici yöntemle de aynı sonuçları vermiştir.

Ongun, Şakir (Balikesir Author), Introduction Following the COVID-19 pandemic, the face-to-face meetings are delayed to a future date, which is still not clear. However, seminars, meetings and conferences are necessary for updating our knowledge and skills. Web-based seminars (webinars) are the solutions to this issue. This study aimed to show the participant behaviour when webinars present at the COVID-19 pandemic era. Methods From December 2017 to July 2020, 58 webinars were broadcasted via the Uropedia, electronic library of SUST. Data of all webinars were collected with the YouTube analytics and application of the Uropedia. Data of streaming webinars included participant behaviours such as content views, engagement time, total unique attendees, average engagement time and the number of audience to leads. Data were split into two groups; group-1 is webinars before COVID-19 (before March 2020) and group-2 is the webinars during COVID-19. Results Total broadcast time and total page view number were found to be 112.6 hours (6761 minutes) and 15 919, respectively. The median participant age was 40.1 y. Median content view and median engagement time were found to be 261.0 and 12.2 minutes, respectively. Comparison of two groups revealed a significant increment in the content views (group-1; 134.0 range = 86.0-87.0 and group-2; 414.0 range = 296.0-602.0, P < .001) and the number of the unique attendees (group 1; 18.0 range = 10.0-26.0 and group-2; 57.0 range = 27.0-100.0, P < .001) following COVID-19. However, the median engagement time of the audience did not seem to change with the COVID-19 pandemic (group-1; 11.5 range = 10.0-13.3 minutes and group-2; 13.2 range = 9.4-18.1 minutes, P = .12). Conclusion The webinars are effective ways to share information and have many advantages, including low cost, reaching a high number of audiences. Audience number and page visits seemed to increase following the COVID-19 pandemic. However, this era did not seem to affect the critical attitude of the audience, which is engagement time.

International audience; Retrograde ejaculation (RE) is a condition defined as the backward flow of the semen during ejaculation, and when present can result in male infertility. RE may be partial or complete, resulting in either low seminal volume or complete absence of the ejaculate (dry ejaculate). RE can result from anatomic, neurological or pharmacological conditions. The treatment approaches outlined are determined by the cause. Alkalinizing urinary pH with oral medications or by adding sperm wash media into the bladder prior to ejaculation may preserve the viability of the sperm. This article provides a step-by-step guide to diagnose RE and the optimal techniques to retrieve sperm. Copyright

Introduction: Following the Covid-19 pandemic, the face-to-face meetings are delayed to a future date , which is still not clear. However, seminars, meetings, and conferences are necessary for updating our knowledge and skills. The web-based seminars (webinars) are the solutions to this issue. This study aimed to show the participant behavior when webinars present at the Covid-19 pandemic era. Methods: Between December 2017 – July 2020, 58 webinars were broadcasted via the Uropedia, electronic library of SUST. Data of all webinars were collected with the YouTube analytics and application of the Uropedia. Data of streaming webinars included participant behaviors such as content views, engagement time, total unique attendees, average engagement time, and the number of audience to leads. Data were split into two groups; group-1 is webinars before Covid-19 (before March 2020), group-2 is the webinars during Covid-19. Results: Total broadcast time and total page view number were found to be 112.6 hours (6761 min.) and 15919, respectively. The median participant age was 40.1 years. Median content view and median engagement time were found to be 261.0 min., and 12.2 min., respectively. Comparison of two groups revealed a significant increment in the content views (group 1;134.0 range=86.0-87.0 and group 2; 414.0 range=296.0-602.0, p

Ongun, Şakir (Balikesir Author), Introduction: Coronavirus disease 2019 (COVID-19) pandemic caused unprecedented restrictions in outpatient services and surgical practices in urology as in other medical branches as well as in all areas of life. Aim: To investigate whether there have been variations in the presentations of male patients with sexual and reproductive health problems to the outpatient urology clinics during the COVID-19 pandemic and to understand the underlying factors for these variations, if any. Methods: Male patients aged >= 18 years who presented to the outpatient urology clinics in 12 centers across Turkey from February 1, 2020 to June 1, 2020 were retrospectively evaluated. The patients were divided into 2 groups: those who presented to the outpatient clinic from February 1, 2020 to March 11, 2020 comprised the "pre-COVID-19 pandemic period" group, whereas those who presented to the outpatient clinic from March 12, 2020 to June 1, 2020 comprised the "COVID-19 pandemic period" group and compared with each other. Main Outcome Measures: The main outcome of this study was the number and diagnose of patients presented to urology outpatient clinics. Results: Andrological problems were detected in 721 of 4,955 male patients included in the study. During the COVID-19 pandemic period, there was a significant increase in andrological diagnosis in these patients compared with the pre-COVID-19 pandemic period (n = 293 [17%] vs n = 428 [13.2%], P < .001, respectively). Similarly, there was a statistically significant increase in the number of patients diagnosed with male reproductive or sexual health problems during the COVID-19 pandemic period (n = 107 [6.2%] vs n = 149 [4.6%], P = .016 and n = 186 [10.8%] vs n = 279 [8.6%], P = .013, respectively). The number of patients diagnosed with erectile dysfunction during the pandemic was also significantly higher than the pre-COVID-19 pandemic period (n = 150 [8.7%] vs n = 214 [6.6%], P = .008). Conclusion: Presentations to the outpatient urology clinics owing to andrological problems markedly increased during the pandemic period. Although these problems are of multifactorial origin, psychogenic factors are also considered to significantly trigger these problems. Copyright (C) 2020, The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.

International audience; The current WHO 2010 manual for human semen analysis defines leukocytospermia as the presence of peroxidase-positive leukocytes at a concentration >1×106/mL of semen. Granular leukocytes when activated are capable of generating high levels of reactive oxygen species in semen resulting in oxidative stress. Oxidative stress has been correlated with poor sperm quality, increased level of sperm DNA fragmentation and low fertility potential. The presence of leukocytes and pathogens in the semen may be a sign of infection and/or localized inflammatory response in the male genital tract and the accessory glands. Common uro-pathogens including Chlamydia trachomatis, Ureaplasma urealyticum, Neisseria gonorrhoeae, Mycoplasma hominis, and Escherichia coli can cause epididymitis, epididymo-orchitis, or prostatitis. The relationship between leukocytospermia and infection is unclear. Therefore, we describe the pathogens responsible for male genital tract infections and their association with leukocytospermia. The review also examines the diagnostic tests available to identify seminal leukocytes. The role of leukocytospermia in male infertility and its management is also discussed.

It has become a necessity to use compression algorithms in image data. One of the most used image compression algorithms, JPEG performs lossy compression on an image and the loss varies according to the given quality factor. At low quality factor values, the file size gets smaller and artifacts become noticeable. In high quality factors, quality of image increases but savings from storage space decreases. For this reason, it will be beneficial to balance the file size and image quality in order to both maintain image quality and save space. The aim of this study is to determine the quality factor value, where the ratio between file size and image distortion is optimum, by using deep learning methods. In the study, a proposed data extraction method was trained with dense neural networks and the success of the method is compared with experimental results obtained with convolutional neural networks. Calculation of image distortion was carried out using SSIM (Structural Similarity Index). In the results obtained, the proposed method has 9.36% more accuracy than CNN in determining the quality factor., Görüntü verisinde sıkıştırma algoritmalarının kullanılması bir gereklilik haline gelmiştir. En çok kullanılan görüntü sıkıştırma algoritmalarından biri olan JPEG, görüntü üzerinde kayıplı bir sıkıştırma gerçekleştirmekte ve verilen kalite faktörüne göre bu kayıp değişmektedir. Düşük kalite faktörlerinde dosya boyutu küçülmekte fakat bozulma gözle görülür hale gelmektedir. Yüksek kalite faktörlerinde ise kalite artmakta fakat dosya boyutundan edilen sıkıştırma karı azalmaktadır. Bu sebeple hem görüntü kalitesini korumak hem de yer kazancı sağlamak için dosya boyutu ve görüntü kalitesi arasındaki dengenin sağlanması faydalı olacaktır. Bu çalışmanın amacı, dosya boyutu ve görüntüdeki bozulmanın arasındaki oranın en iyi (optimum) olduğu kalite faktörünü derin öğrenme yöntemleri kullanarak belirlemektir. Yapılan çalışmada önerilen bir veri çıkarma yöntemi yoğun sinir ağları (dense neural networks) ile eğitilmiş ve yöntemin başarısı evrişimsel sinir ağları ile yapılan denemelerle karşılaştırılmıştır. Görüntüdeki bozulmanın hesaplanmasında SSIM (Structural Similarity Index) kullanılmıştır. Elde edilen sonuçlarda önerilen yöntem kalite faktörünün belirlenmesinde CNN kullanılmasına göre %9.36 daha fazla doğruluk oranına sahip olmuştur.

PURPOSE The aim of this study is to identify the changes in patient age and stone sizes with technological advancement over time. METHODS This study was conducted retrospectively with 404 patients (504 renal units) who underwent percutaneous nephrolithotomy (PCNL) between January 1997 and June 2020. Patient characteristics and trends on instrument preferences were investigated. RESULTS Median age was 7 (1-18) years. Male to female ratio was 1.48:1 (301/203). Median stone burden was 2 cm2 (0.20-25) and median operative time was 90 minutes (20-240). The stone-free rate was 74.6%. Patients were divided into four groups according to the size of the instrument. It was found that the size of sheath used increased significantly with increasing age and stone burden. The micro-PCNL group had the shortest hospitalisation and lowest blood transfusion rate. Chronologically categorised four equal groups were compared to analyse changing patient profiles and trends. Median patient age, stone burden, operation time, sheath size, blood transfusion and complication rates decreased significantly with time. However, the use of tracts smaller than 20F and the number of patients with previous intervention increased significantly. CONCLUSION Our study demonstrated that the patient's age and stone size at the time of initial diagnosis decrease over time while miniaturisation techniques increase in paediatric urology.

Introduction:The literature contains few studies that focus on the relationship between International Society of Urological Pathology (ISUP) score upgrade and complete blood count (CBC) parameters for patients with low-risk prostate cancer and studies achieved inconclusive results.Methods:We retrospectively analyzed our institutional database for patients with prostate cancer who underwent radical prostatectomy (RP) between 1994 and 2017. In total, we included 633 patients with low-risk prostate cancer in the study. We investigated the effects of clinicopathologic factors on ISUP score upgrade. Moreover, we compared RP pathologic outcomes between the patients with and without ISUP score upgrade.Results:The mean age and follow-up periods were 61.09±6.61 years and 41.9±1.8 months, respectively. ISUP score upgrade was observed in 207 patients (32.7%). In multivariate analysis, high prostate-specific antigen (PSA) density and percentage of positive cores were found to be significantly associated with ISUP score upgrade ( p = 0.003 and p = 0.003, respectively). The neutrophil–lymphocyte ratio, platelet–lymphocyte ratio, monocyte–lymphocyte ratio, and eosinophil–lymphocyte ratio were found to have no effect on ISUP score upgrade ( p = 0.856, p = 0.353, p = 0.128, and p = 0.074, respectively). The percentage of tumors, surgical margin positivity, seminal vesicle invasion rate, and extraprostatic extension rate in RP pathology were higher in patients with ISUP score upgrade ( p < 0.001, p < 0.001, p < 0.001, and p < 0.001, respectively).Conclusions:Approximately one-third of the patients in our series had ISUP score upgrade in RP pathology. PSA density and the percentage of positive cores were found to be the factors significantly associated with ISUP score upgrade. CBC-related factors had no effect on ISUP score upgrade.

To assess the clinical variables that effect progression in patients with viable tumor after post-chemotherapy lymph node dissection due to disseminated non-seminomatous germ-cell tumors. We performed a retrospective analysis of 32 patients with viable tumor after PC-RPLND, operated between 1990 and 2016. Patients were categorized into 2 groups as favorable and non-favorable (intermedia and poor) according to International Germ Cell Consensus Classification (IGCCC). Tumor size was determined as the largest dimension of retroperitoneal mass. Clinical factors and adjuvant chemotherapy were evaluated to impact on recurrence free survival (RFS) and overall survival (OS). The median age of the patients and follow-up duration were 28.5 (17–51) years and 51.5 (4–253) months, respectively. 5-year RFS and OS were 57.8–66.8%, respectively. On univariate analysis, percentage of viable tumor, IGCCC risk group, primary site, second-line chemotherapy and surgical margin status were significant for RFS (p = 0.034, p = 0.002, p

Objective: To evaluate the short-term complications of various cystoplasty techniques in pediatric population and determine the predicting factors. Material and Methods: The data of 206 patients (94 males, 112 females) who underwent augmentation cystoplasty between 1991-2016 were analysed retrospectively. Short-term complications within 30 days were evaluated according to the modified Clavien classification system. Grade III, IV, and V were grouped major complications. Chronic renal Disease (CRD) was defined as increasing serum creatinine levels above the normal age-adjusted values. Clinical factors and associated procedures to the surgery (Mitrofanoff procedure, bladder outlet procedures, ureteral anti-reflux surgery) were evaluated to predict overall and major complications. Results: The mean age was 9.8±4.7 years and female/male ratio was 112/94. Overall complication rate was 32% (66 patients) and distributed to Clavien class I, II, IIIb, IVa as 18 (8,7%), 33(16%), 14 (6,81%), 1 (0.48%) patients; respectively. There was no mortality. Age, PUV aetiology and CRD were significant predictor of complication on univariate analysis (p=0.026, p=0.048 and p=0.045, respectively). Age and preoperative CRD were significant on multivariable analysis (p=0.015, OR=0.918 and p=0.046, OR=2.134). Major complications occurred in 15 (7.3%) patients. Bladder exstrophy epispadias complex (BEEC), preoperative CRD, anti-reflux surgery, ileal augmentation were significant parameters on univariate analysis (p=0.007, p=0.003, p=0.043, and p=0.022, respectively). For major complications where BEEC, CRD and ileal AC were significant parameters on multivariate analysis (p=0.009, OR=7.837; p=0.003, OR=9.649, p=0.047, OR=4.241, respectively). Conclusion: Augmentation cystoplasty and associated procedures have acceptable complication rate for pediatric group. Preoperative renal disease and younger age are associated with complications. For major complications, Bladder exstrophy epispadias complex, ileal augmentation and preoperative renal disease are risk factors.

Objective To investigate the diagnostic properties of 3 different scoring systems (Dysfunctional Voiding Symptom Score [DVSS], Dysfunctional Voiding and Incontinence Symptoms Score [DVISS], Incontinence Symptom Index-Pediatric [ISI-P, for children older than 11 years]) that are used to evaluate lower urinary tract symptoms in pediatric population. Materials and Methods Eighty-four participants were evaluated by detailed history, physical examination, 3 different scoring systems (DVSS, DVISS, ISI-P), ultrasonography, and uroflowmetry. Depending on the tests, cases were stratified as healthy or lower urinary tract symptoms (LUTS) by 2 urologists who were blinded to the questionnaires. Patients were reevaluated by the same tests and questionnaires 3 months after treatment. Diagnostic properties of questionnaires were calculated. Additionally, parents were asked to scale the improvement of symptoms subjectively from 0% to 100% to correlate to each of the three scoring systems. Results The mean ages of the normal and the LUTS groups were 9.1 ± 2.6 years and 10.1 ± 2.8 years, respectively ( P = .301). Gender (male:female) distribution was 21:21 in the LUTS group and 25:17 in the control group ( P = .381). In terms of diagnosis, DVISS has the highest accuracy (sensitivity: 81%, specificity: 97.6%, accuracy: 89%) followed by ISI-P (sensitivity: 55.6%, specificity: 100%, accuracy: 82%) and DVSS (sensitivity: 54.8%, specificity: 97.6%, accuracy: 76%). The similar order was valid for the 23 patients older than 11 years (accuracy for DVISS: 87%, for ISI-P: 82%, and for DVSS: 78%). In terms of response to treatment, all 3 tests showed good correlation with parents' ratings (DVSS: P P = .005, ISI-P: P = .042). Conclusion Although DVISS had the highest accuracy in distinguishing the patients from healthy controls, all 3 questionnaires seem to be equivalent for the evaluation of response to treatment.

Aim:The primary goal of urologic management in children with neurogenic bladder is to reduce the risk of urinary tract infection (UTI) and associated renal injury. We aimed to evaluate the use of antibacterial-coated clean intermittent catheterization (CIC) catheters for neurogenic bladder patients in comparison with standard catheters.Material and Methods:We performed a retrospective study of 144 neurogenic bladder patients aged 6-16 years old, who received CIC at two major centers between January 2007 and June 2016. Group 1 consisted of children used antibacterial coated (chitosan) catheter (n=55), group 2 of children used standard CIC without antibacterial (n=42) and group 3 of children used standard CIC returned into antibiotic coated CIC mimimum 6 months (n=29). Febrile urinary tract infection and asymptomatic bacteriuria were evaluated among patients with antibacterial coated or standard catheters. We also focused on a subgroup of patients with high risk of urinary tract infection (grade 3> vesicoureteral reflux, previously scar formation in renal scintigraphy).Results:Totally 126 patients (89 female, 37 male) were involved in this study. The mean age of the study group was 9.6±2.6 years (range 6 to 16) and the mean follow-up 58±14 months (min: 22, max: 69). There was no significant difference between three groups for asymptomatic bacteriuria and febrile UTI frequencies. However, febrile UTI frequencies and de nova scar formation in renal scintigraphy were higher in previously defined subgroup of patients with high risk of urinary tract infection in group 2 than group1 and 3.Discussion:Both antibiotic coated and standard CIC can be used in children with neurogenic bladder with similar complication rates. Patients with high risk of urinary tract infection (higher than grade 3 vesicoureteral reflux, dilated ureter, previously de nova scar formation in renal scintigraphy) will benefit from antibacterial-coated catheters rather than standard ones.