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Estrogen receptors in prostate cancer (PCa) are a subject of debate. The aim of the present study was to investigate whether estrogen receptor-α (ERα) and estrogen receptor-β (ERβ) impact the biochemical recurrence (BCR) of non-metastatic PCa after surgery. Following the application of the exclusion criteria, data from 108 patients who underwent laparoscopic radical prostatectomy between January 2011 and December 2019 were retrospectively evaluated. A total of 36 patients with BCR constituted the BCR group. The control group was formed using the Propensity Score Matching (PSM) method with a 1:2 ratio, including parameters with well-studied effects on BCR. The median follow-up time was 74.3 (range, 30–127.5) months in the BCR group and 66.6 (range, 31.5-130) months in the control group. Pathology specimens from the two groups were immunohistochemically stained with ERα and ERβ antibodies. Logistic regression analysis and survival analysis were performed. No differences in clinicopathological characteristics were detected between the two groups. The patients with ERα(−)/ERβ(+) staining results had a significantly fewer BCRs than other patients (P=0.024). In the logistic regression analysis, patients with ERα(−)/ERβ(+) PCa also had a significantly lower risk of recurrence (P=0.048). In the survival analysis, the 5-year BCR-free survival rate of patients with ERα(−)/ERβ(+) PCa was higher than that of other patients (85.7 vs. 66.1%; P=0.031). Excluding the effects of well-studied risk factors for recurrence by the PSM method, the present study showed that ERα and ERβ have prognostic value for non-metastatic PCa. The 5-year BCR-free survival rate is significantly higher in patients whose PCa tissue has ERα(−)/ERβ(+) staining results.

Objective: The best therapeutic option for renal tumours smaller than 7 cm is partial nephrectomy. The aim of this study was to compare the positive surgical margin (PSM) rates, recurrence rates and oncological outcomes between laparoscopic partial nephrectomies and open partial nephrectomies at a single tertiary referral centre. Materials and Methods: We included patients with renal tumours treated with partial nephrectomies between January 2008 and December 2016 in the study. We retrospectively reviewed the patients' demographic data, surgical reports, clinical charts, laboratory results and histopathological reports. Binary regression analysis was used to assess the impact of the tumour diameter, laterality, polarity and localization for PSM. Results: We included a total of 215 patients in the study. The mean preoperative and postoperative haemoglobin and creatinine levels, blood loss, time of surgery and follow-up periods was similar between the two groups. The mean ischaemic time in the open partial nephrectomy group was significantly lower than that of the laparoscopic partial nephrectomy group (p

Mesane kanseri tedavisinde yaygın olarak uygulanan radikal sistoprostatektomi materyallerinde klinik bulgu vermeyen, insidental prostat kanserlerine sıklıkla rastlanmaktadır. Çalışmamızda, merkezimizde radikal sistoprostatektomi uygulanan hastalarda prostat kanseri insidansını, evresini, histopatolojik özellikleri ve bu tümörlerin prognoza etkisini değerlendirmeyi amaçladık. 2006 - 2020 arasında merkezimizde mesane kanseri nedeniyle radikal sistoprostatektomi uygulanan 499 hastaya ait dosyalar retrospektif olarak incelendi. İnsidental prostat tümörü 141 (%28,3) olguda tespit edildi. Tümörlerin tamamı prostat asiner adenokarsinomu olarak tanı aldı. 127 (%90,1) hasta pT2, 10 (%7,1) hasta pT3a ve 4 (%2,8) hasta pT3b tümöre sahipti. 35 (%24,8) hastada klinik ol arak önemli prostat kanseri mevcuttu. Ameliyat öncesi artmış PSA değerine sahip 14 hastadan 4’ü klinik olarak anlamlı prostat tümörüne sahipti. Radikal sistoprostatektomi materyallerinde insi- dental prostat tümörü saptanma oranları yüksektir ancak tümörlerin çoğu klinik olarak önemsiz grupta yer alır. Serum PSA değerinin ameli- yat öncesi insidental tümörü tespitinde faydası sınırlıdır. İnsidental prostat tümörüne sahip hastalarda olumsuz klinik seyir izlenmemekle birlikte prognozun asıl belirleyicisi mesane tümörüdür. Incidental prostate cancers are frequently encountered in radical cystoprostatectomy materials, which are widely used in the treatment of bladder cancer. We aimed to evaluate incidental prostate cancer’s incidence, stage, histopathological features and their effect on prognosis in patients who underwent radical cystoprostatectomy in our center. 499 patients who underwent radical cystoprostatectomy for bladder cancer between 2006 and 2020 were retrospectively evaluated. Incidental prostate tumor was detected in 141 (28.3%) cases. All tumors were diagnosed as prostate acinar adenocarcinoma. 127 (90.1%) patients had pT2, 10 (7.1%) patients had pT3a and 4 (2.8%) patients had pT3b tumor. Clinically significant prostate cancer was present in 35 (24.8%) patients. Of the 14 patients with an increased PSA level preoperatively, 4 had a clinically significant prostate tumor. Incidence of incidental prostate tumor is high in radical cystoprostatectomy materials, but most of them are clinically insignificant. The benefit of preoperative evaluation of serum PSA for the detection of incidental tumors is controversial. Although an unfavorable clinical course is not observed in patients with incidental prostate tumor, the main determinant of prognosis is the bladder tumor.

Objective: To assess the effects of obesity on the surgical success and perioperative results and continence status in laparoscopic radical prostatectomy (LRP). Materials and Methods: The results of 300 consecutive patients undergoing LRP between April 2004 and January 2014 were analyzed retrospectively. Twenty patients were excluded from the study, thus, 280 patients remained. The patients were separated into 3 groups according to their body mass index. Based on this classification, group 1 (< 25 kg/m(2)) was normal, group 2 (25- 30 kg/m(2)) was overweight, and group 3 (> 30 kg/m(2)) was obese. The demographic data, intraoperative results, pathological results, and states of continence were compared among the groups. Results: There were 81 patients in group 1, 152 patients in group 2, and 47 patients in group 3. There were no significant differences when the groups were compared according to age and prostate specific antigen values. The intraoperative blood loss was high in group 3 only. Moreover, the estimated blood loss, transfusion, operative time, bilateral nerve- sparing rate, hospitalization days, and complication rate were similar between the groups. There were no significant differences when the pathological results were compared according to the positive surgical margins and Gleason scores. Although the continence rates in group 3 were significantly low 6 months after the operation (p< 0.05), the results were similar at 1 year (p= 0.738). Conclusion: LRP can be applied confidently in obese patients as well as normal and overweight patients., NA

Aim: Amyloid A amyloidosis is a rare complication of chronic inflammatory conditions. Most patients with amyloid A amyloidosis present with nephropathy and it leads to renal failure and death. We studied clinical characteristics and survival in patients with amyloid A amyloidosis. Methods: A total of 81 patients (51 males, 30 females) with renal biopsy proven amyloid A amyloidosis were analyzed retrospectively. The patients were divided into good and poor outcomes groups according to survival results. Results: Most of the patients (55.6%) had nephrotic range proteinuria at diagnosis. Most frequent underlying disorders were familial Mediterranean fever (21.2%) and rheumatoid arthritis (10.6%) in the good outcome group and malignancy (20%) in the poor outcome group. Only diastolic blood pressure in the good outcome group and phosphorus level in the poor outcome group was higher. Serum creatinine levels increased after treatment in both groups, while proteinuria in the good outcome group decreased. Increase in serum creatinine and decrease in estimated glomerular filtration rate of the poor outcome group were more significant in the good outcome group. At the time of diagnosis 18.5% and 27.2% of all patients had advanced chronic kidney disease (stage 4 and 5, respectively). Median duration of renal survival was 65 +/- 3.54 months. Among all patients, 27.1% were started dialysis treatment during the follow-up period and 7.4% of all patients underwent kidney transplantation. Higher levels of systolic blood pressure [hazard ratios 1.03, 95% confidence interval: 1-1.06, p = 0.036], serum creatinine (hazard ratios 1.25, 95% confidence interval: 1.07-1.46, p = 0.006) and urinary protein excretion (hazard ratios 1.08, 95% confidence interval: 1.01-1.16, p = 0.027) were predictors of end-stage renal disease. Median survival of patients with organ involvement was 50.3 +/- 16 months. Conclusion: Our study indicated that familial Mediterranean fever constituted a large proportion of cases and increased number of patients with idiopathic amyloid A amyloidosis. Additionally, it was observed that patient survival was not affected by different etiological causes in amyloid A amyloidosis. Resumo Objetivo: A amiloidose AA é uma complicação rara de condições inflamatórias crônicas. A maior parte dos pacientes com amiloidose AA apresenta nefropatia, que leva à insuficiência renal e à morte. Estudaram-se as características clínicas e a sobrevida em pacientes com amiloidose AA. Métodos: Analisaram-se retrospectivamente 81 pacientes (51 homens, 30 mulheres) com amiloidose AA comprovada por biópsia renal. Os pacientes foram divididos em grupos de desfecho bom e ruim de acordo com os resultados de sobrevida. Resultados: A maior parte dos pacientes (55,6%) tinha proteinúria na faixa nefrótica no momento do diagnóstico. Os distúrbios subjacentes mais frequentes foram a febre familiar do Mediterrâneo (FFM, 21,2%) e a artrite reumatoide (10,6%) no grupo de desfecho bom e a malignidade (20%) no grupo de desfecho ruim. Somente a pressão arterial diastólica no grupo de desfecho bom e o nível de fósforo no grupo de desfecho ruim foram mais elevados. Os níveis séricos de creatinina aumentaram após o tratamento em ambos os grupos, enquanto a proteinúria diminuiu no grupo de desfecho bom. O aumento na creatinina sérica e a diminuição na TFGe do grupo de desfecho ruim foram mais significativos no grupo de desfecho bom. No momento do diagnóstico, 18,5% e 27,2% de todos os pacientes tinham doença renal crônica avançada (estágios 4 e 5, respectivamente). A duração média da sobrevida renal foi de 65 ± 3,54 meses. Entre todos os pacientes, 27,1% iniciaram tratamento de diálise durante o período de seguimento e 7,4% de todos os pacientes foram submetidos a transplante renal. Níveis elevados de pressão arterial sistólica [taxas de risco (HR) 1,03, intervalo de confiança (IC) de 95%: 1 a 1,06, p = 0,036], creatinina sérica (HR 1,25, IC 95%: 1,07 a 1,46, p = 0,006) e excreção urinária de proteínas (HR 1,08, IC 95%: 1,01 a 1,16, p = 0,027) foram preditores de doença renal terminal. A mediana da sobrevida de pacientes com comprometimento de órgãos foi de 50,3 ± 16 meses. Conclusão: O presente estudo indicou que a FFM constituiu uma grande proporção de casos e crescente quantidade de pacientes com amiloidose AA idiopática. Adicionalmente, observou-se que a sobrevida do paciente não foi afetada pelas diferentes causas etiológicas na amiloidose AA.

Kistik nefroma böbreğin nadir görülen multikistik benign tümörüdür. Hastanemizde 2005-2017 yılları arasında 1625 hasta böbrekte kitle nedeniyle opere olmuştur. Bu hastaların %1.2’si kistik nefroma tanısı almıştır.Çalışmamızda 2005– 2017 yılları arasında, kistik nefroma tanısı almış 20 olgu, retrospektif olarak incelenerek, klinik ve histopatolojik özellikleri ortaya konuldu. Hasta kayıtlarından elde edilen bilgiler, klinik hikâyeleri, klinik tanısı ve cerrahi materyalin histopatolojik özelliklerine göre not edildi. Olguların 15’i kadındı. Yaş aralığı 1 - 63 arasındaydı. 12 vakada lomber veya yan ağrısı şikayeti mevcuttu. 14 hastaya radikal, 6 hastaya parsiyel nefrektomi yapıldı. Olguların takiplerinde rekürrens görülmedi. Kistik nefromalar klinik ve radyolojik olarak diğer kistik renal tümörlerle karışabilir, ayırıcı tanıda histopatolojik inceleme gereklidir. Cystic nephroma is a rare multicystic benign tumor of kidney. In our hospital, 1625 patients were operated because of a kidney mass between 2005 and 2017. 1.2% of these patients were diagnosed as cystic nephroma. In our study we evaluated retrospectively the clinical and histopathologic features of 20 patients with cystic nephroma that were diagnosed between 2005-2017. Demographics of patients, clinical history, clinical diagnosis and pathologic characteristics of the specimen were assessed. 15 patients were female. Ages ranged from 1 to 63 years. 12 patients had lomber or flank pain. 14 patients underwent radical and 6 patients underwent partial nephrectomy. There was no recurrence during follow-up. Cystic nephromas mimic other cystic renal neoplasms clinically and radiologically, necessitating histopathological examination for definitive diagnosis.

28. Ulusal Patoloji Kongresi’nde (27-30 Ekim 2018, Ankara) Poster bildiri olarak sunulmuştur. Amiloidoz, sistemik veya lokalize tutulum gösterebilen, amiloid proteinin ekstraselüler matrikste birikimi ile karakterize heterojen bir hastalık grubudur. Lokalize amiloidoz, amiloid birikiminin tek bir dokuya sınırlı kalması sonucu gelişen ve lokalize bir kitle oluşturması nedeniyle de klinik olarak maligniteleri taklit edebilen non-neoplastik bir hastalıktır. Bu çalışmada vezikula seminalis ve duktus deferens yerleşimli lokalize amiloidoz serimizin sunulması ve bu tümörlerin klinikopatolojik özelliklerinin literatür bilgileri eşliğinde sunulması amaçlanmıştır. Çalışmamızda Uludağ Üniversitesi Tıp Fakültesi Tıbbi Patoloji Anabilim Dalı arşivi taranarak 2013–2018 yılları arasında tanı almış vezikula seminalis ve duktus deferens yerleşimli lokalize amiloidoz olguları incelendi. Sistoprostatektomi prosedürü uygulanan 4 olguda sadece vezikula seminalislerde, prostatektomi prosedürü uygulanan 6 olgunun 5'inde hem vezikula seminalis hem de duktus deferenslerde ve 1 olguda ise sadece duktus deferenslerde lokalize amiloidoz saptandı. Olguların tamamında subepitelyal yerleşimli, eozinofilik, amorf, homojen madde şeklinde gözlenen birikimlere Kongo red boyaması uygulandı. Kongo red histokimyasal boyaması ile bu alanlarda kiremit kırmızısı boyanma saptandı ve polarize ışık mikroskobi bakısında elma yeşili refle verdiği tespit edildi. Sonuç olarak, lokalize amiloidoz çok farklı lokalizasyonlarda saptanabilmekle birlikte vezikula seminalis ve duktus deferens lokalizasyonunda nispeten nadirdir. İnsidental saptanmaları nedeniyle biyopsi örnekleri değerlendirilirken amiloid birikimi açısından da olguların değerlendirilmesi ve gerekli görülen olgularda Kongo red boyamasının yapılması önem arz etmektedir. Amyloidosis is a heterogeneous group of diseases characterized by accumulation of amyloid protein in the extracellular matrix, which may be systemic or localized. Localized amyloidosis is a non-neoplastic disease that results from limited amyloid accumulation to a single tissue, and clinically mimics malignancies forming a localized mass. In this descriptive study, we aim to report our series of localized amyloidosis in the vesicula seminalis and the ductus deferens as well as clinicopathologic characteristics of these tumors in literature data. In this study, we examined the localized amyloidosis cases of the vesicula seminalis and the ductus deferens, diagnosed between 2013 and 2018 by searching the archives of Uludag University, Faculty of Medicine, Department of Pathology. The sites where localized amyloidosis was detected include only the vesicula seminalis in four cases who underwent a cystoprostatectomy procedure, both the vesicula seminalis and the ductus deferens in five out of six cases with a prostatectomy procedure, and only the ductus deferens in one case. The deposits in the form of subepithelial, eosinophilic, amorphous and homogeneous substance were treated with Congo Red staining in all cases. The histochemical treatment with Congo Red yielded tile reddish staining in these areas, making them appear apple-green on the polarized light microscopy. In conclusion, localized amyloidoses are relatively rare in the vesicula seminalis and the ductus deferens, although they can be detected at very different locations. Since they are incidentally detected, it is important to evaluate a case in terms of amyloid deposits while examining biopsy specimens, as well as staining with Congo Red when necessary.

Üretral karünküller, postmenopozal kadınlarda daha sık gözlenen üretral meatusun benign polipoid kitleleridir. Çalışmada 2005 – 2013 yılları arasında, üretral karünkül tanısı almış olgular, geriye dönük incelenerek, klinik ve histopatolojik özellikleri ortaya konuldu. Üretral karünküller benign ve malign tümörleri taklit edebilen lezyonlardır. Özellikle semptomatik veya malignite şüphesi taşıyan üretral karünküllerden biyopsi örneklemesi yapılmalıdır. Urethral caruncle is a benign polypoid mass of the urethral meatus in primarily postmenopausal women. This study analyzes patients with urethral caruncule which were diagnosed between 2005-2013. Their clinical and histopathological features were evaluated retrospectively. Demographics of patients, clinical history, clinical diagnosis and pathologic characteristics of the specimen were assessed. Urethral caruncle may clinically mimic benign and malignant conditions. Biopsy should be indicated only if the mass has other characteristics that raise suspicion of malignancy.

28. Ulusal Patoloji Kongresi’nde (Ankara, 27-30 Ekim 2018) Poster Bildiri olarak sunulmuştur. Müsinöz tübüler ve iğsi hücreli karsinoma; oldukça nadir görülen renal epitelyal bir neoplazmdır. Olgu sunumumuzda müsinöz tübüler ve iğsi hücreli karsinoma saptanan olgu sunulmuş ve hastalığın epidemiyolojisi, radyolojik bulguları ve histopatolojik özellikleri ilgili literatür eşliğinde kısaca tartışılmıştır. 43 yaşındaki erkek hasta, sol yan ağrısı şikayeti ile başvurduğu dış merkezde yapılan radyolojik incelemede, sol böbreğinde kitle saptanması üzerine ileri tanı ve tedavi için hastanemiz üroloji polikliniğine yönlendirildi. Yapılan fizik muayene ve tetkikler doğrultusunda renal hücreli karsinoma düşünülen olguya radikal nefrektomi operasyonu planlandı. Materyalden hazırlanan kesitlerin mikroskobik incelemesinde; miksoid stroma içerisinde, eozinofilik sitoplazmalı, iğsi şekilli, düşük gradeli nükleer özellikler gösteren hücrelerin, uzamış veya birbiri ile anastomozlaşan tubul benzeri yapılanmalarından oluşan tümöral lezyon dikkati çekti. Histopatolojik ve immünohistokimyasal bulgular doğrultusunda olguya müsinöz tübüler ve iğsi hücreli karsinoma tanısı verildi. Tüm renal neoplazilerin %1'den azını oluşturan bu tümörlerin prognozu, diğer epitelyal böbrek tümörlerine kıyasla daha iyidir. Bu nedenle müsinöz tübüler ve iğsi hücreli karsinoma olgularını ayırıcı tanıya girdikleri papiller renal hücreli karsinoma olgularından ayırmak son derece önemlidir. Mucinous tubular and spindle cell carcinoma has recently been recognized as a rare distinctive type of renal epithelial carcinoma. In our case report, we report a case of mucinous tubular and spindle cell carcinoma and epidemiology, radiological findings and histopathologic features of the disease were briefly discussed in literature data. A 43-year-old male was referred to our urology outpatient clinic for further diagnosis and treatment after a mass on the left kidney was detected in a radiological examination at the external center with the complaint of left flank pain. Radical nephrectomy was planned for the case who was thought to have a diagnosis of renal cell carcinoma according to physical examination and tests. In the microscopic examination of the specimen, tumoral lesion consisting of elongated or anastomotic tubulus-like structures of the spindle shaped cells with eosinophilic cytoplasm indicating low-grade nuclear features consistent in myxoid stroma were observed. The patient was diagnosed as mucinous tubular and spindle cell carcinoma according to the histopathological and immunohistochemical findings. These tumors, which constitute less than 1% of all renal neoplasms, have a better prognosis than other epithelial renal tumors. Therefore, it is very important to distinguish mucinous tubular and spindle cell carcinoma cases from papillary renal cell carcinoma cases in differential diagnosis.

Background We aimed to compare the protective effects of tadalafil and diltiazem on renal histology after ischemia and reperfusion injury in a rat model of shock wave lithotripsy. Methods A total of 40 adult, male Sprague-Dawley rats were randomized into four groups as follows; control group (group C), group S (SWL + nephrectomy), group T (SWL + tadalafil given before nephrectomy) and group D (SWL + diltiazem given before nephrectomy). Both kidneys were evaluated regarding tubular damage, peritubular fibrosis and heat shock protein-70 (HSP-70) immune-expression of glomeruli, cortical and medullar collector tubules on light microscopy. Results HSP-70 levels of cortical and medullar collector tubules, tubular damage and peritubular fibrosis scores were decreased in group T compared with group S. Similarly, HSP-70 immunostaining levels on cortical and medullar collector tubules, tubular damage and peritubular fibrosis scores were decreased in group D compared with group S. No significant difference was detected between group D and group T for all parameters. Conclusion As a result, shock waves induced renal cell damage due to increment of HSP-70 levels, morphological irregularity in tubules and increased peritubular fibrosis. Tadalafil and diltiazem had beneficial effects in decreasing renal tissue damage which was caused by SWL (Tab. 2, Fig. 6, Ref. 29).

Objective: To comparatively evaluate the traditional interrupted knot-tying and running suture renorrhaphy with Monocryl (R) in laparoscopic partial nephrectomy (LPN). Materials and Methods: A retrospective analysis of 62 consecutive patients undergoing LPN using traditional interrupted knot-tying suture renorrhaphy (Group 1; n= 31) or running suture technique renorrhaphy with 2-0 monofilament polyglecaprone (Monocryl (R), Ethicon) (Group 2; n= 31) from December 2011 to October 2015 at the University. All patients underwent LPN performed by an experienced laparoscopic surgeon. The demographic, perioperative and postoperative parameters were compared between the groups, and the effect of both suture techniques on the warm ischemic time (WIT) and trifecta were evaluated. Results: The running suture renorrhaphy with Monocryl (R) reduced WIT, estimated blood lost and length of hospitalization stay significantly without increasing postoperative complication rate during LPN in comparison with interrupted knot-tying suture. Conclusion: The renorrhaphy using the running suture with Monocryl (R) is an effective and safe technique with the advantage of shortening WIT even in more challenging and larger tumors during LPN.

Introduction: Nitric oxide (NO) plays an important role in the ischemia and reperfusion process. In this study, we aimed to examine the effect of L-arginine, tadalafil, and their combination for preventionof the ischemia reperfusion injury after testis torsion in rats.Methods: A total of 40 adult, male Sprague-Dawley rats were allocated into five groups. Three hours of left testicular torsion was performed in each group, excluding the control group. While the ischemia reperfusion (I/R) group had no treatment, I/R + Arg group received L-arginine, I/R + Td group received tadalafil and I/R + Arg + Td group received tadalafil and L-arginine 30 minutes before the detorsion. Then the left testis was untwisted for four hours of reperfusion. After bilateral orchiectomy, lipid peroxidation (LPx) and glutathione (GSH) activities were examined in testicular tissue.Spermatogenesis was evaluated with Johnsen’s score.Results: LPx levels of the I/R group were found to be significantly higher than for groups that received drugs for both testes (p

ObjectiveTo evaluate the immunohistochemical staining pattern of caudal type homeobox 2 (CDX2) protein in germ cell tumours (GCTs) of the testis.MethodsThis study reassessed archival tissue samples collected from patients diagnosed with primary and metastatic testicular GCTs for CDX2 immunoreactivity using standard immunohistochemical techniques. Positive nuclear immunostaining was evaluated with regard to both the staining intensity and the extent of the staining.ResultsTissue sections from primary and metastatic testicular GCTs ( n = 104), germ cell neoplasia in situ (GCNis) ( n = 5) and benign testicles ( n = 15) were analysed. The GCNis and benign testicular tissues showed no immunoreactivity for CDX2. Strong and diffuse staining of CDX2 was demonstrated only in the mature colonic epithelium of teratomas in both primary and metastatic GCTs. CDX2 positivity in other tumours (one pure yolk sac tumour, one yolk sac component of a mixed GCT and one pure seminoma) was infrequent, and was only weak and focal.ConclusionsCDX2 immunostaining should be interpreted based on both the staining intensity and the extent of staining so as not to cause misdiagnosis. Teratomas with colonic-type epithelium should be considered in the differential diagnosis if a metastatic tumour with an unknown primary shows prominent CDX2 immunostaining.

Introduction: We compared the cost-effectiveness of laparoscopic simple prostatectomy (LSP) vs open prostatectomy (OP). Patients and Methods: A total of 73 men treated for benign prostatic hyperplasia were enrolled for OP and LSP in groups 1 and 2, respectively. The findings were recorded perioperative, including operation time (OT), blood lost, transfusion rate, conversion to the open surgery, and the complications according to the Clavien Classification. The postoperative findings, including catheterization and drainage time, the amount of analgesic used, hospitalization time, postoperative complications, international prostate symptom score (IPSS) and International Index of Erectile Function (IIEF) scores, the extracted prostate weight, the uroflowmeter, as well as postvoiding residual (PVR) and quality of life (QoL) score at the postoperative third month, were analyzed. The cost of both techniques was also compared statistically. Results: No statistical differences were found in the preoperative parameters, including age, IPSS and QoL score, maximum flow rate (Q(max)), PVR, IIEF score, and prostate volumes, as measured by transabdominal ultrasonography. No statistical differences were established in terms of the OT and the weight of the extracted prostate. No differences were established with regard to complications according to Clavien's classification in groups. However, the bleeding rate was significantly lower in group 2. The drainage, catheterization, and hospitalization times and the amount of analgesics were significantly lower in the second group. The postoperative third month findings were not different statistically. Only the Q(max) values were significantly greater in group 2. While there was only a $52 difference between groups with regard to operation cost, this difference was significantly different. Conclusion: The use of LSP for the prostates over 80 g is more effective than the OP in terms of OT, bleeding amount, transfusion rates, catheterization time, drain removal time, hospitalization time, consumed analgesic amount, and Q(max) values. On the other hand, the mean cost of the LSP is higher than OP. Better effectiveness comes with higher cost.

The study investigated immunoexpression of amyloid A (AA) in clear cell renal cell carcinoma (CCRCC) and evaluated its clinicopathologic correlation, particularly in disease progression. Expression of AA protein was evaluated in patients with CCRCC by immunohistochemistry. 146 cancerous tissue samples from 86 male and 60 female patients were studied. The relationship between AA protein expression and TNM stage, nuclear grade, renal capsule invasion, perirenal invasion, and survival of the patients were assessed. Thirty four percent of CCRCC cases were AA positive. The positive AA immunoexpression was related to higher Fuhrman nuclear grade, presence of perirenal invasion of the tumor, and poor survival of patients with CCRCC. There was not any statistically significant difference between patients' gender, status of capsule invasion, and stages of the tumor in terms of AA immunoexpression. Tumor stage (Hazard ratio (HR) = 7.76 (95% CI: 2.43-24.8) for stage 3 and HR = 29.9 (95% CI: 6.97-128.32) for stage 4) and AA immunoexpression (HR = 2.16 (95% CI: 1.01-4.64) were found to be associated with survival of the patients with CCRCC in Cox regression analysis. Immunoexpression of AA was increased in high grade CCRCCs. Immunoexpression of AA was associated with poor survival in patients with CCRCC. Thus, AA staining might be used as a useful immunohistological marker for the prediction of poor prognosis in renal cell cancer.

Granülomatöz prostatitler, prostatın benign inflamatuar hastalıklarının %1’ini oluşturmaktadır. Pek çok olguda granülomatöz prostatitin sebebi bilinmemekle birlikte, prostatın transüretral rezeksiyonu, iğne biyopsisi, açık prostatektomi ve mesane içine bacillus Calmette-Guerin (BCG) uygulanması sonrası meydana gelebilir. Bu çalışmamızın amacı prostat örneklemelerinden granülomatöz prostatit tanısı almış hastalarımızın klinik ve patolojik özelliklerini araştırmak ve literatür eşliğinde değerlendirmektir. Granulamatous prostatitis accounts for %1 of benign inflammatory conditions of the prostate. In most cases the cause of granulamatous prostatitis are unknown but may occur after transurethral resection and needle biopsy of prostate, open prostatectomy and instillation of bacillus Calmette-Guerin (BCG) into the bladder. The aim of this study is to evaluate the clinical and pathologic features of our patients who had a diagnosis of granulamatous prostatitis in their prostate specimens and discuss in the light of the literature.

Ksantogranülomatöz piyelonefritis, nedeni bilinmeyen nadir görülen bir hastalıktır. Yaygın olmayan bu renal parankimin kronik destrüktif lezyonu, uzun süreli üriner sistem obstrüksiyonu ve enfeksiyonu ile ilişkilidir. Bu retrospektif çalışmada, hastanemizde 2007-2012 yılları arasında Ksantogranülomatöz piyelonefritis tanısı almış 11 vaka tekrar gözden geçirildi. 11 ksantogranülomatöz piyelonefritis hastasının 7’si (% 63. 6) kadın, 4’ü (% 36. 4) erkekti. Ortalama yaş 59’dur. Ağrı ve ateş en sık ortaya çıkan semptomdu. Hastaların tamamında hastalık tek taraflı olup hepsine total nefrektomi uygulanmıştı. Operasyon öncesi ksantogranülomatöz piyelonefritis tanısı koymak oldukça güçtür ve nefrektomi özellikle diffüz vakalarda tedavi seçeneğidir. Xanthogranulomatous pyelonephritis is an uncommon disorder of unknown etiology. That is an uncommon chronic destructive granulomatous process of renal parenchyma in association with long-term urinary tract obstruction and infection. This retrospective study was undertaken to review the xanthogranulomatous pyelonephritis cases presented at our hospital from 2007-2012. Xanthogranulomatous pyelonephritis was diagnosed in 11 cases. Of the 11 patients with XGP, 7 were women (63. 6 %) and 4 (36. 4%) were men. Their mean age was 59 years. Flank pain was the most common presenting symptom followed by fever. All patients had unilateral disease and underwent total nephrectomy of the affected nonfunctional kidney. Preoperative diagnosis of xanthogranulomatous pyelonephritis may pose difficulty and nephrectomy remains the treatment of choice especially in diffuse cases of xanthogranulomatous pyelonephritis.