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Background. The gold standard treatment method for end-stage renal disease (ESRD) is renal transplantation (RT). RT can be done with open or minimally invasive surgical methods. We aimed to compare the outcomes between patients who underwent robot-assisted renal transplantation (RART) and open renal transplantation (ORT). Methods. Data of the patients who underwent ORT or RART in two institutions between June 2015 and February 2020 were retrospectively reviewed. Patients who underwent live donor RT were included, and all donor nephrectomy procedures were performed by the laparoscopic technique. Demographic data, ischemia times, anastomosis times, operation times, and postoperative complications were recorded. Results. 98 patients were included in the ORT group, while 91 patients were included in the RART group. There was a significant difference between the two groups regarding mean patient age. While total ischemia time was 86.9 ± 7 minutes in the RART group, it was calculated as 71.2 ± 3.3 minutes in the ORT group, with a significant difference. The anastomosis time was significantly shorter in the ORT group than in the RART group. The incision length and duration of hospital stay were significantly shorter, visual analogue scores were significantly lower, and estimated blood loss was less in the RART group than in the ORT group. Conclusion. Both ORT and RART are effective and safe methods for treating ESRD. According to our study, RART is associated with relatively longer ischemia times but lower complication rates and higher patient comfort.

Background and Aims: The aim of this study was to evaluate if the tumor heterogeneity index can predict the aggressiveness of prostate cancer (PCa) in patients diagnosed by magnetic resonance imaging (MRI) fusion biopsy. Material and Methods: Patients who underwent MRI fusion prostatic biopsy between July 2019 and December 2020 were retrospectively reviewed. Tumor heterogeneity index (coefficient of variation [CV]) and PI-RADS v2.1 scoring were analyzed by using multiparametric MRI. The patients were divided into 3 groups according to the risk classification, and the correlation between tumor heterogeneity index and PCa aggressiveness was studied by using apparent diffusion coefficient (ADCmean and ADCcv), Gleason score (GS), and risk classifications. Results: One hundred two patients were included in this study. Patients were evaluated as low-risk (group 1) (n = 35), moderate-risk (group 2) (n = 37), and high-risk (group 3) (n = 30). ADCmean values for all groups were significantly different (p < 0.0001). ADCcv tumor heterogeneity index values were higher in group 2 and group 3 by the score increases in subgroups according to GS, while being higher than group 1 (p < 0.001). The multivariate analysis revealed that prostate-specific antigen, PI-RADS, ADCmean, and ADCcv values were predictive for tumor aggressiveness. Conclusion: ADCcv value as a tissue texture parameter can be used as a new biomarker to evaluate tumor aggressiveness in patients with PCa.

Percutaneous nephrolithotomy (PNL) for upper urinary tract stones is a minimally invasive, effective treatment modality. Despite its high success rates, its potential complications pose a risk. In this study, we aimed to determine the risk factors associated with bleeding which is one of PNL's most important complications.The data of patients who underwent PNL between January 2017 and December 2018 were retrospectively analyzed. The median reduction in post-operative hemoglobin levels compared to preoperative levels was found to be 1.6 g/dl, which was accepted as the threshold value. The patients with hemoglobin decrease above the threshold were assigned as Group 1, and below the threshold as Group 2. Pre-operative, perioperative data, and stone characteristics of the patients were recorded.169 patients, 85 patients in Group 1 and 84 patients in Group 2 were included in the study. The mean age of Group 1 was significantly higher (47.4±7.9 and 32±9.4 years, respectively, p=0.001) Sixteen in Group 1 (18.8%) and six in Group 2 (7, 1%) had a diagnosis of hypertension (HT) and a significant difference was found (p=0.038). The average stone burden was 2733±1121.3 mm3 in Group 1, and 2326.5±975.6 mmIn this study; advanced age, presence of HT, and high stone burden were found to be predictive of reductions in hemoglobin levels. Furthermore, a correlation of decreased hemoglobin levels was detected with operative times and occurrence of complications.

Amaç: Akut idrar retansiyonu (AİR) benign prostat hiperplazisi (BPH) hastalarında en önemli komplikasyonlardan biridir ve tedavisi genellikle akut dönemde üretral kateterizasyondur. AİR ve üretral kateter yerleştirilmesinin serum PSA seviyelerinde bir artışa neden olabileceğini gösteren çalışmalar vardır. Bu çalışmada amacımız, AİR sonrası üretral kateter yerleştirilen hasta grubunda artmış PSA düzeyleri ile prostat kanseri (PCa) insidansı arasındaki ilişkiyi araştırmaktır.Gereç ve Yöntemler: AUR nedeniyle kalıcı bir üretral kateteri olan 77 hastada, yüksek PSA seviyeleri nedeniyle yapılan prostat biyopsileri ve daha sonra klinik BPH için yapılan cerrahi tedaviler retrospektif olarak incelendi. Hastaların yaş, prostat hacimleri, biyopsi öncesi total serum PSA ve PSA dansiteleri kaydedildi. Biyopsi veya cerrahi örnek sonuçlarına göre total PSA oranları, PSA dansiteleri ve prostat hacimleri PCa’nın saptandığı (n = 6) ve saptanmadığı (n = 71) gruplar için karşılaştırıldı.Bulgular: Hastaların yaş ortalaması 65.2 ± 3.9 idi. Ortalama prostat hacmi 64.1 ± 12.8 g, ortalama serum total PSA seviyesi 9.2 ± 4.2 ng / mL ve ortalama serum PSA dansitesi 0.15 ± 0.08 mg / mL / g olarak ölçülmüştür. Serum total PSA düzeyi ≤4.0, 4-10, 10-20 ve >20 olan PSA gruplarında PCa prevalansı sırasıyla % 0, % 4,3, % 13,4 ve % 20 olarak tespit edildi. Toplam PSA düzeyleri ve PSA dansiteleri, PCa tespit edilen grupta istatistiksel olarak daha yüksek bulundu.Sonuç: AİR sonrası üretral kateter yerleştirilen hastalarda PCa insidansı düşüktür. Bu hastalar için prostat biyopsisi sadece seçilmiş vakalarda yapılmalıdır., Objective: Acute urinary retension (AUR) is one of the most important complications in benign prostate hyperplasia (BPH) patients and its treatment is generally urethral catheterization in acute period. There are studies showing that AUR and urethral catheter placement may cause an increase in serum PSA levels. Our objective in this study was to investigate the relation between increased PSA levels and prostate cancer (PCa) incidence in the patient group after AUR and urethral catheter placement.Materials and Methods: 77 patients who had an indwelling urethral catheter due to AUR, performed prostate biopsy due to high PSA levels and then surgical treatment for clinic BPH were retrospectively examined. Age, prostate volumes, pre-biopsy total serum PSA and PSA densities were noted. Total serum PSA rates, PSA densities and prostate volumes were compared for the groups that PCa was detected (n=6) and not detected (n=71) according to biopsy or surgical specimen results.Results: Mean age of the patients was 65.2±3.9 years. Mean prostate volume was measured as 64.1±12.8 g, mean serum total PSA level as 9.2±4.2 ng/mL and mean serum PSA density as 0.15±0.08 mg/mL/g. In PSA groups with a serum total PSA level of ≤4.0, 4-10, 10-20 and >20, PCa prevalence rates were detected 0%, 4.3%, 13.4% and 20%, respectively. Total PSA levels and PSA densities were found statistically higher in PCa detected group.Conclusion: PCa incidence is low in patients who were placed urethral catheter after AUR. For these patients prostate biopsy should be performed only in chosen cases.

To report and discuss the treatment of ipsilateral upper ureteral and renal stones by laparoscopic ureterolithotomy with concomitant pyelolithotomy using flexible cystoscope.A total of 19 patients (14 men and 5 women) underwent laparoscopic retroperitoneal ureterolithotomy with concomitant pyelolithotomy using flexible cystoscope through the ureterotomy site. The mean age of the patients was 37.9 (22-61) years. Stones were on the right side in 12, on the left side in 7, and multiple in 6 patients. All ureteral stones were located in the upper ureter. Most renal stones were in the pelvis or in the calices.All procedures were completed laparoscopically without conversion to open surgery. Mean operation duration was 86.5 (range: 80-93) minutes, thus operation duration was prolonged by a mean of 24.4 minutes in patients with concomitant stone extraction. Fifteen cases were treated using flexible cystoscope and a nitinol basket; in the remaining four cases holmium laser lithotripsy was performed. Complete stone clearance was confirmed by postoperative imaging in all patients.Laparoscopic ureterolithotomy with concomitant pyelolithotomy is a feasible and effective technique for patients with large ureteral stone and low renal stone burden.nbsp.