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Introduction: Surgery is one of the treatment alternatives for prostate cancer, and robotic-assisted laparoscopic prostatectomy (RALP) has become the new trend in the past decade. There is no consensus yet for surgeons who will perform RALP whether they need to be trained or experienced in laparoscopy. In this study, it was aimed to investigate the effectiveness of the surgeon’s laparoscopy experience in the perioperative and postoperative results of RALP patients. Material and method: Patients who underwent RALP were retrospectively screened. The first 20 cases done by surgeons in both groups and 40 cases in total were included in the study. Surgeons with laparoscopy training were designated as group 1, and surgeons without laparoscopy training were designated as group 2. Patient’s age, preoperative prostate-specific antigen (PSA) value, prostate biopsy pathology, radical prostatectomy pathology, surgical margin positivity, extracapsular extension, and seminal vesicle invasion status, blood transfusion rate, operation time, length of hospital stay, and 1-year follow-up potency and urinary incontinence rates were compared. Results: There was no difference between the two groups in terms of age, preoperative PSA, preoperative biopsy results, blood transfusion rates, operation times, and the length of hospital stay of the patients. When the postoperative oncological and functional results of the patients were examined, there was no difference between the two groups in the prostatectomy pathology ( p = 0.895), extracapsular extension (pT3a) ( p = 0.519), positive surgical margin (pSM) ( p = 0.723), and seminal vesicle invasion (pT3b) ( p = 0.756). Potency and urinary incontinence rates were similar in both groups at the end of one year follow-up ( p = 0.327, 0.500 respectively). Conclusions: Based on our study, it is clearly seen that regardless of the surgeon’s experience of laparoscopy, it can be safely preferred when looking at the oncological and functional results of RALP.

Objective: To investigate the effect of the presence of severe hydronephrosis on percutaneous nephrolithotomy (PNL) outcome in patients who underwent PNL operation with one-shot dilatation technique. Materials and methods: Medical data of 989 patients underwent PNL operation in our clinic between 2012 and 2018 were retrospectively reviewed. We included 373 of the patients underwent PNL operation due to renal pelvic stone, who were older than 18 years of age, who did not have any urinary tract abnormality, and had no previous history of open renal stone operation. Patients were divided into two groups according to the presence of severe hydronephrosis and absence of hydronephrosis. These two groups were compared in terms of age, gender, body mass index (BMI), number of stones, stone burden, operation duration, fluoroscopy time, hospitalization time, hemoglobin and creatinine change, complications, and stone free rate. Results: There was no statistically significant difference between the groups in terms of age, gender, BMI, stone number, stone size, stone density, operation duration, fluoroscopy time, and hospitalization duration. The mean change in hemoglobin was 1.5 g/dL in group 1 and 1.1 g/dL in group 2. This difference was statistically significant ( p = 0.006). Postoperative blood transfusion was required for 3 patients (2.1%) in group 1 and 12 patients (5.1%) in group 2. This difference was statistically significant ( p Conclusion: Only the presence of severe hydronephrosis was found to be associated with the change in hemoglobin and postoperative blood transfusion.

Objective To investigate the effect of testicular histopathology on the success of microscopic testicular sperm extraction (mTESE) and the factors that could predict the success of mTESE in patients with non-mosaic Klinefelter syndrome (KS). Material and methods Forty-one KS patients diagnosed with non-obstructive azoospermia (NOA) who had undergone mTESE at our clinic were included in the study. The patients were divided into 5 groups according to the histopathology results: hyalinisation of tubules (HT), sertoli cell only (SCO), early maturation arrest (EMA), late maturation arrest (LMA), and hypospermatogenesis (HS). The groups were compared with regard to age, duration of infertility, hormone profile, testicular volume, and sperm retriveal rate. The clinical features of the patients with mTESE from whom sperm could or could not be obtained were also compared with the aim of investigating the predictive value of testicular histopathology and the other variables for prediction of the success of mTESE. Results Sperm could be obtained through mTESE in 13 out of 41 patients (31.7%). A statistically significant difference was determined between the groups with regard to the rate of sperm collection. No significant difference was determined between the histopathology groups with regard to the other variables. A statistically significant difference was determined between the groups from whic sperm could be collected or not with regard to age, Johnsen criteria, SCO, EMA and LMA variables. Multi-variate analysis revealed that age and Johnsen score were the independent variables predictive for success of mTESE. Conclusion The present study has revealed that impairment in testicular histopathology negatively affects the success of mTESE and that it is a predictive factor for the success of mTESE in patients with KS. Increased patient age was also determined to negatively affect the success of mTESE and the operation was demonstrated to be more successful before 34 years of age.

OBJECTIVE: The objective of this study was to evaluate the uroflowmetry test results performed for normal and urgent desire to void and their correlation with International Prostate Symptom Score (IPSS) values in adult male patients having lower urinary tract symptoms (LUTS) complaints. MATERIAL AND METHODS: In this prospective study, a total of 83 patients were included. With a normal desire to void, maximum flowrate (Qmax)-normal, average flowrate (Qaverage)-normal, and void volume (VV)-normal values were obtained. Residual urine volume was examined by suprapubic ultrasound within 5 minutes following uroflowmetry, and calculated. The maximum bladder volume (MBV)-normal value was calculated by adding the residual-normal volume and VV-normal values. The same procedures were repeated the next day with the sensation of urgency, Qmax-urgency, Qaverage-urgency, VV-urgency, residue-urgency, MBV-urgency values were obtained. RESULTS: Statistically significant difference was determined for all parameters, and higher values were obtained in the urgency group for all parameters (p

Objective Infectious complications after transrectal ultrasound-guided prostate biopsy (TRUS-PB) can range from asymptomatic bacteriuria and febrile or non-febrile urinary tract infection (UTI) to sepsis. Cleaning of rectal mucosa with topical antiseptics such as povidone iodine or chlorhexidine before the procedure are alternative prophylaxis methods. We aimed to investigate the effects of these two different topical antiseptic agents on infectious complications and their superiority to each other. Material and methods The study was conducted with 200 patients. Rectal mucosa cleansings were performed in 50 patients with povidone iodine and 49 patients with chlorhexidine. The remaining 101 patients did not receive any antiseptic treatment. The results were examined according to the hospital admissions or hospitalization for the first 30 days after the procedure due to UTI, body temperature >38.5°C, sepsis, hematuria, rectal bleeding, and urinary retention. Results The mean age of study population was 63.3±7.26 years, and the mean prostate specific antigen value was 13.96±29.5 ng/mL. Acute prostatitis occurred in 14 patients (7%), 9 of whom were hospitalized due to sepsis after TRUS-PB. Statistically significant less acute prostatitis was observed in those patients who were treated with topical rectal antisepsis (topical rectal antisepsis 2% vs. no rectal antisepsis 12.1%, p=0.01). Chlorhexidine and povidone iodine were not superior to each other in terms of inhibiting the development of acute prostatitis (chlorhexidine 2% vs. povidone iodine 2%, p=1.00). Conclusion Rectal mucosal cleansing with chlorhexidine or povidone iodine before TRUS-PB prevented the development of sepsis due to acute prostatitis. We recommend that this effective method, which is easy to apply, cheap, reliable, easily tolerated should be used in all prostate biopsy practice.

Objective:The aim of this study was to investigate the use and types of hemostatic agents (HAs) used during partial nephrectomy (PN) and the relationship of the number of these agents used during surgery with tumor size, RENAL nephrometry score (NS), peroperative ischemia time, and postoperative pathology results.Materials and Methods:Records of patients, who had undergone PN in our clinic due to renal mass between January 2013 and February 2019, were retrospectively reviewed. Our study included 71 patients who were administered one or more HAs during PN. Demographic characteristics, operative data, and pathological results of patients, who were administered one or more HAs during PN, were recorded.Results:Cellulose-based agents and polytetrafluoroethylene pledgets were the most frequently used HAs (78.8% and 38%, respectively). The patients were divided into two groups according to tumor size (0-4 cm and larger than 4 cm tumors), RENAL NS (low and intermediate-high score), ischemia time (0-20 min and longer than 20 min), and tumor pathology result (benign and malignant tumor), and the number of HAs used in each group was compared. When the groups were compared separately in terms of number of HAs used, no statistically significant difference was found between the groups (p=0.323, p=0.183, p=0.618, and p=0.131, respectively).Conclusion:HAs are frequently used in our clinic to achieve hemostasis. There was no statistically significant difference in the number of HAs used between the groups.

Aim: The most important stage of percutaneous nephrolithotomy (PNL), which is an effective and reliable method in the treatment of large and complex kidney stones, is to create a suitable and effective tract after the accessory is provided. For this purpose, different techniques such as Amplatz, baloon and Alken dilators have been described. We aimed to compare the efficacy and safety of single-step Amplatz dilatation technique with stepwise Amplatz dilatation technique in pediatric PNL patients. Methods: This is a retrospective cohort study. We evaluated the data from 75 PNL operations performed on 72 pediatric patients in our center within the last decade. The data from single-step dilation technique patient group (group 1, n: 41) and the stepwise dilatation technique patient group (group 2, n: 34) was compared in terms of durations of fluoroscopy and surgery, stone-free and complication rates, pre and postoperative hematocrit levels and blood transfusions rates. Results: There was no significant difference between the groups in terms of demographic data, mean stone burden, duration of surgery, decrease in hematocrit, blood transfusion rates, stone-free rate and complication rates. The median fluoroscopy durations of group 1 and group 2 were 120 and 220 seconds, respectively. Duration of surgery and fluoroscopy were significantly shorter in the single-step dilatation group Conclusion: PNL is a safe and effective procedure for pediatric stone diseases. Performing this procedure with a single-step dilatation technique ensures that children are less exposed to radiation.

Objective:Ureteral double-J stents are extensively used in urology practice. We aimed to investigate the bacterial colonization rate and predominant microorganisms on ureteral double-J stents in patients with negative urine cultures in a prospective study.Materials and Methods:A total of 35 double-J ureteral stents from 35 consecutive patients were examined. The cyctoscopically removed stents were divided into three parts as upper, middle and lower then sent for the microbiologic examination with a urine sample just taken before stent removal. The samples were inoculated on sheep blood agar and eosin-methylene blue agar culture mediums. The growth of >1000 colony-forming units/mL was considered significant. The antimicrobial susceptibility test was performed with 10 broad spectrum antibiotics.Results:Bacterial colonies were found in 20% of 35 ureteral stents. The most frequently isolated bacteria was Staphylococcus epidermidis, followed by Escherischia coli and Enterococcus faecalis. Bacterial colonization was revealed in all parts of the stents in 71.4% cases. The stent indwelling time was correlated with stent culture positivity (p=0.035). However, no correlation was detected with gender, age and stent colonization (p≥0.05).Conclusion:Negative urine culture result does not always rule out positive stent culture. Even not routinelly recommended, stent culture could be useful for treatment of a possible postoperative urinary tract infection and sepsis in high risk patients who undergo endourologic surgery.

WOS: 000461022400007, Objective: We investigated the protective and therapeutic effects of ozone therapy (OT) on cisplatin (CP)-induced testicular damage. Materials and Methods: Thirty healthy adult male Wistar rats were divided into five groups consisting of 6 animals each: 1) control, 2) CP, 3) OT, 4) OT + CP and 5) CP + OT groups. Histopathological findings, Johnsen scores, thiobarbituric acid-reactive substances (TBARS), glutathione (GSH), superoxide dismutase (SOD), catalase, and GSH peroxidase (GPx) levels were evaluated. Results: CP caused a significant decrease in testicular weight and Johnsen score compared to the control group. In addition, TBARS level was significantly higher, whereas GSH, SOD, catalase and GPx levels were significantly lower in the CP group when compared to the control group. Pre- and post-CP OT significantly increased GSH, SOD, catalase and GPx levels and decreased TBARS level. Also, testicular weight and Johnsen score were increased with OT. Conclusion: The present study showed that OT is protective against CP-induced testicular damage. OT may be beneficial to patients who underwent CP chemotherapy.

Objective:The aim of this study is to evaluate the success and complication rates of percutaneous nephrolithotomy (PNL) with multiple single step access in patients with staghorn kidney stones.Materials and Methods:A total of 118 patients with staghorn kidney stones, who underwent PNL in our clinic between 2008 and 2015, were included in the study. All patients were examined with non-contrast abdominal computed tomography before the operation. Demographic data of patients, operation details, intra- and postoperative complications and additional interventions were evaluated.Results:The mean age of the patients included in the study was 49.6 years. The mean operative time was 139.4 minutes and the mean fluoroscopy time was 126.9 seconds. Postoperative residual stone was detected in 28% of the patients. Postoperative fever was observed in 19 patients (16.2%), and sepsis developed in 3 (2.5%) of them. Additional postoperative procedures were required in 11 patients (9.3%). No patient was lost due to complications. Operation success and complication rates were compatible with the literature.Conclusion:For staghorn stones, PNL with multiple single step dilatation technique can be used as an effective and safe method in adult patients.

Summary Introduction Various agents have been tested as preventive treatments for ischemia/reperfusion (IR) damage. In this study, we have investigated for the first time in the literature the efficacy of injection of amniomax (AMX) into testicular parenchyma, which is a commercial medium of rat amniotic fluid, in preventing testicular IR damage related to testicular torsion. Objective This study aims to evaluate whether or not amniomax has an effect on experimental IR damage in rat testes using biochemical and histopathological methods based on data in the literature. Even if testicular torsion is repaired surgically in early term injury because of de IR damage still occurs. Is it possible to reduce the ischemia reperfusion injury with amniotic fluid and increase the success of treatment? Study design 40 male Wistar albino rats were included. Four groups were formed with 10 rats in each group: Sham, Ischemia/Reperfusion (IR), injection 1 min before detorsion (AMX-BD), injection 1 min after detorsion (AMX-AD). Total Oxidant Status (TOS) and Oxidative Stress Index (OSI) were computed for oxidative stress, and Total Antioxidant Status (TAS) levels were computed for the antioxidant system, for both serum and tissue. Necrosis and microcalcification levels were assessed in the evaluation of testicular histology. P Results AMX-AD group has low necrosis degree than IR, Mean serum and tissue levels of TAS, TOS, and OSI parameters were respectively determined as; for TAS: 0.64 ± 0.11 and 0.96 ± 0.25 mmol Trolox Equivalent/L; for TOS: 6.71 ± 0.87 and 9.40 ± 1.03 μmol H2O2 equivalent/L; for OSI: 11.94 ± 3.74 and 10.70 ± 4.23 arbitrary unit. Discussion Our study has investigated for the first time in the literature the efficacy of amniotic fluid in preventing testicular IR damage, and used amniomax (AMX) for this purpose. The limitation of our study may be the small number of rat in the groups. Conclusion We think an injection after detorsion is more favorable considering that the AMX-AD group demonstrated significantly lower levels of TOS in serum and tissue and OSI in serum, and significantly higher serum levels of TAS compared to the AMX-BD group, as well as the fact that the morphological protection effect was only observed for injections performed immediately after detorsion. Download : Download high-res image (178KB) Download : Download full-size image Summary Figure . Statistical outcomes concerning necrosis and microcalcification for the three dependent groups (IR, AMX-BD, AMX-AD).

Introduction: Malignant mesothelioma (MM) of tunica vaginalis is a very rare tumor and it has a poor prognosis. It is not easy to diagnose the disease preoperatively because there is a lack of comprehensive studies and information about the disease. We would like to present our two cases with severe scrotal edema and hydrocele, which were debrided perioperatively due to scrotal necrosis, followed by radical inguinal orchiectomy and subsequently diagnosed as MM of tunica vaginalis. Case 1: A 74-year-old male patient with bilateral scrotal swelling for 6 months. Right radical inguinal orchiectomy was performed. The pathology result of right radical inguinal orchiectomy material was compatible with malignant mesothelioma of tunica vaginalis. Case 2: A 90-year-old male patient with complaints of right scrotal swelling for 3 years. A right radical inguinal orchiectomy was performed. The pathology result of right radical inguinal orchiectomy material was compatible with malignant mesothelioma of tunica vaginalis. Conclusion and discussion: MM has a very poor prognosis therefore early treatment plan should be made. Surgery is the main treatment for malignant mesothelioma of the testis. Although chemotherapy and radiotherapy play an active role in the treatment of metastatic disease, surgery is the first-line therapy in the treatment of the tumor. Also; long-term hydrocele, recurrent epididymitis, scrotal edema can make it harder to detect the tumor diagnosis. MM should be considered in such patients. Necrosis and abscess appearance was not mentioned before in published case reports. In this respect, it should not be ignored the long-term hydrocele situation and the appearance of abscess-epididymitis that cannot be treated properly.

Objective We aimed to determine the effect COVID‐19 pandemic on the daily urology practice of the level 3 centre located in one of the most affected regions in Turkey. We also aimed to assess anxiety and depression levels of patients whose procedures and surgeries had to be postponed due to COVID‐19‐related restrictions. Methods The number of patients admitted to the outpatient clinic, outpatient procedures, emergency consultation requests, hospitalised patients and the total number of surgeries between March 10, 2020 and June 15, 2020 were evaluated. These numbers were compared with the same period of 2019. Subsequently, patients who could not be operated or whose elective surgeries were postponed between March 10, 2020 and June 15, 2020 were determined(n:96). These patients were asked to fill out Beck Depression Inventory(BDI) and State‐Trait Anxiety Inventory(STAI). The presence of difference between the baseline anxiety levels and the anxiety levels during the COVID‐19 pandemic was investigated. Afterwards, these patients were divided into two groups based on planned procedures as oncological group (group1) and non‐oncological group (group2). The presence of a difference between the anxiety and depression levels between the groups was investigated. Results There was a drastic decline in number of patients in all assessed parameters. The least amount of change was seen in the number of emergency consultations. The evaluation of anxiety and depression scores of the patients showed a significant difference between their STAI‐S and STAI‐T scores (51.8 ± 9.3, 38.2 ± 7.5, respectively)(P

Objective: The aim of this study is to investigate the use of serum gamma-glutamyl transpeptidase level as a biomarker especially in seminomatous subtype disease in testicular tumor patients and to investigate the superiority of biomarkers currently in use, and to examine the role of serum gamma-glutamyl transpeptidase levels in chemotherapy response, maintenance and nephrotoxicity in patients receiving cisplatin-based chemotherapy.Material and Methods: This study was carried out by retrospectively scanning the data of patients diagnosed with testicular tumor and underwent radical inguinal orchiectomy. Age, tumor histology, subtype and stage, tumor side and size, presence of microlithiasis and testicular intraepithelial neoplasia, tumor size and rete testis invasion in patients with seminoma, presence of lymphovascular invasion and percentage of embryonal cancer in non-seminomatous patients, preoperative and postoperative gamma-glutamyl transpeptidase, alpha feto protein, lactate dehydrogenase and beta human chorionic gonadotropin levels, postoperative treatment (chemotherapy and retroperitoneal lymph node dissection), cisplatin therapy status, and post-therapy serum creatinine levels and chemotherapy response were examined in the study.Results: Our study was carried out with a total of 96 patients after exclusion criteria were applied. It was observed that the preoperative and postoperative levels of serum gamma-glutamyl transpeptidase value were not correlated with alpha feto protein, lactate dehydrogenase and beta human chorionic gonadotropin in both seminoma and nonseminomatous testicular cancers. Age, tumor histology, seminoma subtype, rete testis invasion in seminoma and tumor size in seminoma were found to be significantly correlated as factors that could predict the level of gamma-glutamyl transpeptidase.Conclusion: The serum gamma-glutamyl transpeptidase enzyme appears to be a new biomarker independent of current biomarkers in seminoma patients. It has been concluded that it is a biomarker that supports rete testis invasion and tumor being larger than 4 cm which are known as bad risk factors in patients with classical subtype seminoma with advanced age., Amaç: Bu çalışmanın amacı testis tümörü hastalarında serum gama-glutamil transpeptidaz düzeyinin özellikle seminomatöz alt tipteki hastalıkta bir biyobelirteç olarak kullanılabilirliğinin, mevcut kullanımda olan biyobelirteçlere üstünlüğünün araştırılması ile sisplatin temelli kemoterapi alan hastalarda serum gama-glutamil transpeptidaz seviyelerinin kemoterapi yanıtı, devamı ve nefrotoksisitedeki rollerini incelemektir.Gereç ve Yöntemler: Bu çalışma testis tümörü tanısı alıp radikal inguinal orşiektomi uygulanan hastaların verilerinin retrospektif olarak taranması şeklinde gerçekleştirildi. Yaş, tümör histolojisi, alt tipi ve evresi, tümör tarafı ve boyutu, mikrolithiazis ve testiküler intraepitelyal neoplazi varlığı, seminomlu hastalarda tümör boyutu ve rete testis invazyonu, non-seminomatöz hastalarda lenfovasküler invazyon varlığı ve embriyonel kanser yüzdesi, preoperatif ve postoperatif gama-glutamil transpeptidaz, alfa feto protein, laktat dehidrojenaz ve beta human chorionic gonadotropinin seviyeleri, postoperatif verilen tedavi (kemoterapi ve retroperitoneal lenf nodu diseksiyonu), sisplatin alma durumu ile sonrasında serum kreatinin seviyeleri ve kemoterapi cevabı gibi değişkenler çalışmada incelendi.Bulgular: Çalışmamız, hariç tutma kriterleri sonrası toplam 96 hasta ile gerçekleştirildi. Serum gama-glutamil transpeptidaz değerinin preoperatif ve postoperatif seviyelerinin alfa feto protein, laktat dehidrojenaz ve beta human chorionic gonadotropinin ile hem seminom, hem de nonseminomatöz testis kanserlerinde korelasyonunun olmadığı izlenmiştir. Gama-glutamil transpeptidaz seviyesini predikte edebilecek faktörler olarak yaş, tümör histolojisi, seminom alt tipi, seminomda rete testis invazyonu ve seminomdaki tümör boyutunun anlamlı derecede ilişkili olduğu bulunmuştur.Sonuç: Serum gama-glutamil transpeptidaz enzimi seminom hastalarında şu anki biyobelirteçlerden bağımsız olarak yeni bir biyobelirteç gibi görünmektedir. Daha ileri yaşı olan, klasik alt tipli seminom hastalarında kötü risk faktörleri olarak bilinen rete testis invazyonunu ve tümörün 4 cm’den büyük oluşunu destekleyen bir biyobelirteç olduğu sonucuna ulaşılmıştır.

Background: We compared outcomes of en bloc stapler ligation of the renal hilum with separate Hem-o-lok polymer clip ligation of the renal vessels during laparoscopic nephrectomy (LN). Materials and Methods: Clinical data of patients who underwent LN for renal surgery from January 2009 to December 2015 were collected. Operation time, estimated blood loss, device malfunction rate, open conversion rate, complications and arteriovenous fistula (AVF) formation were evaluated. Results: En bloc stapler ligation and separate clip ligation were performed in 64 and 66 patients, respectively. The mean operative time was 106.8 +/- 20.8 min (range: 70-165) in the en bloc stapler ligation group compared with 112.5 +/- 24.1 min (range: 70-180) in the separate clip ligation group (P = 0.147). The mean estimated blood loss was 141.4 +/- 124.1 ml (range: 25-600) in the en bloc stapler ligation group compared with 147.6 +/- 112.4 ml (range: 25-450) in the separate clip ligation group (P = 0.767). The open conversion was required in 7/64 (10.9%) and 2/66 (3.0%) patients in the en bloc stapler ligation and separate clip ligation groups, respectively (P = 0.093). Stapler device malfunction occurred in 6 patients (9.3%). There were no statistically significant differences in overall complications (P = 0.726), minor (Grade 1-2) complications (P = 0.698) and major (Grade 3-5) complications (P = 0.716). No patient was diagnosed with AVF formation during overall median 33-month (interquartile range: 30, range: 24-96) follow-up. Conclusions: En bloc stapler ligation of the renal hilum during nephrectomy is an effective and safe technique. Although there is no reported AVF formation with en bloc stapler ligation of the renal hilum, longer follow-up is necessary.

Introduction: Voiding symptoms, storage symptoms and post-voiding symptoms together constitute lower urinary tract symptoms (LUTS). Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. The most common finding is lymphadenomegaly. Although infrequent, extranodal sites of involvement such as prostate can be detected. Mantle cell lymphoma (MCL) is a subtype of B cell non-Hodgkin lymphomas. Extranodal involvement findings such as prostate may be observed. In this case report, we will present a case in which we performed an open suprapubic prostatectomy (Freyer’s) and had CLL as a result of pathology, and a case whose pathology was MCL after transurethral resection of the prostate. Case 1: A 60-year-old male patient with LUTS for 6 years. Open suprapubic prostatectomy (Freyer’s) was performed on the patient. The pathology result of the prostatectomy material was compatible with CLL involvement. Case 2: A 62-year-old male patient with LUTS for 4 years. Transurethral resection of the prostate (TUR-P) was performed on the patient. The pathology result of the prostate was compatible with MCL involvement. Discussion and Conclusion: There are limited number of cases have been reported about CLL pathology after prostatectomy due to benign prostatic obstruction (BPO). There is no study indicating how often CLL pathology is seen after open prostatectomy or TUR-P due to BPO. In patients with CLL pathology after RRP, open prostatectomy, TUR-P, the need for additional surgery, the difference in prognosis or the difference between the treatment have not been shown in the studies. It should be kept in mind that patients with leukocytosis, lymphocytosis, cytopenias, and LUTS in their clinical presentation and who have not yet been diagnosed with CLL and other hematological malignancies such as mantle cell lymphoma may also have prostate gland involvement and can be diagnosed incidentally by any prostatic intervention.

Objective: To contribute to the explanation of the etiology of enuresis, which is quite prevalent, by investigating its relationship with urine pH and density. Methods: A total of 45558 children were included in the study. Based on screening results, 44201 children without enuresis were assigned to Group 1 and 1357 children with enuresis to Group 2. Complete urinalysis results of all children who had been identified were scanned and values of urine pH and density were obtained. Intergroup differences with regard to urine pH and density were analyzed using Student’s t-test. A p value of

Cancers of unknown primary (CUP) that we rarely encounter,conversely rank fourth in cancer-related deaths in males and females. In this case, we aimed to present how the primary of an inguinal mass, which could have been diagnosed as CUP in the 80’s, could be detected using advanced immunohistochemical methods.

Objective: First objective of this study was to find out factors influencing development of postoperative systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PNL). Secondary objective was to point out the role of preoperative neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in SIRS estimation. Method: The data of 756 patients that underwent PNL for kidney stones between 2012 and 2019 were evaluated retrospectively. Patients were divided into 2 groups as non-SIRS and SIRS group. The effects of NLR, PLR and other operative and demographic variables on development of SIRS were investigated. Multivariate logistic regression analysis that was performed on variables that were significant in the univariate analyses was used to establish independent risk factor for post-PNL SIRS. Results: Univariate analysis revealed a significant association between presence of SIRS and preoperative PLR (p120.5, NLR >2.75, and blood transfusions should be monitored closely due to the possible development of serious complications.

Mesane içi kalküller mesanede bulunan taşlar veya kalsifiye olmuş materyallerdir. İdrarla temas eden yabancı cisimler mesane taşlarına neden olabilmektedir. Yabancı cisim örnekleri arasında dikiş materyali, klipsler, kateterler, üreteral stentler, üriner inkontinans meşleri veya intrauterin cihazın göçü sayılabilir. 63 yaşında kadın hasta üroloji kliniğimize yaklaşık 1 yıldır var olan idrar yaparken yanma, sık idrara çıkma ve mikst tip idrar kaçırma şikayeti ile başvurdu. Hastanın iki yıl önce geçirilmiş abdominal histerektomi ve Burch kolposüspansiyon öyküsü mevcuttu. Çekilen bilgisayarlı tomografide 2,9x2,6 cm ebatlarında mesane taşı saptandı. Hastaya Holmium (Ho: YAG) lazer ile sistolitotripsi yapıldı. Mesane taşının mesane duvarına bir polipropilen sütür ile bağlı olduğu görüldü. Sütür materyali endoskopik olarak çıkarıldı. Hastanın 2 yıllık takibinde herhangi bir şikayeti bulunmamaktadır. Mesanede emilmeyen sütür materyalinin varlığı, idrar yolu enfeksiyonu ve taş oluşumunun iyi bilinen bir nedenidir ve histerektomi ve kolposüspansiyon operasyonlarının tanımlanmış komplikasyonlarındandır. Çeşitli dikiş malzemelerinin litojenik özelliklerine ilişkin bilgiler, ne yazık ki, sadece in vitro ve hayvansal in vivo çalışmalarla sınırlıdır. İnsanlarda dikiş materyallerine bağlı taş oluşumuyla ilgili deneyimlerse vaka raporlarından ibarettir. Litojenitenin sütür materyalinin uzun ömürlülüğü ile ilişkili olduğu ve yapılan çalışmalarda, emilmeyen sütürlerle taşlaşmanın daha yüksek oranda gerçekleştiği görülmüştür. Tedavi ise taşın parçalanmasını ve taşa sebebiyet veren yabancı cismin çıkarılmasını içerir., Bladder calculies are stones or calcified materials found in the bladder. Foreign bodies that come into contact with the urine may cause bladder stones. Examples of foreign body include suture materials, clips, catheters, ureteral stents, urinary incontinence meshes or migration of an intrauterine device. A 63-year-old female patient was admitted to our urology clinic with dysuria, frequent urination and mixed type urinary incontinence for a year. The patient had a history of abdominal hysterectomy and Burch colposuspension two years ago. Computerized tomography of the patient revealed a bladder stone measuring 2.9 x 2.6 cm.The patient underwent cystolithotripsy with Holmium (Ho: YAG) laser. The bladder stone was found to be attached to the bladder wall by a polypropylene suture. The suture material was removed endoscopically. The patient has no complaints during the 2-year follow-up. . The presence of nonabsorbable suture material in the bladder is a well-known cause of urinary tract infection and stone formation, and defined complication of hysterectomy and colposuspension. . Information on the lithogenic properties of various suture materials is unfortunately limited to only in vitro and in vivo animal studies. In humans, experience with stone formation related to suture materials is limited to case reports. It has been observed that lithogenicity is related to the longevity of the suture material and in the studies carried out, it has been observed that the rate of calcification with non-absorbable sutures is higher. Treatment includes disintegration of the stone and removal of the foreign body causing the stone.

Purpose To compare the effects of two border-age groups: young adults and octogenarians on survival of sporadic renal cell carcinoma (RCC). Methods We reviewed the records of 1619 patients that underwent radical or partial nephrectomy due to RCC between January 2004 and December 2018 in two high-volume centers. Patients were divided into two groups based on their age: = 80 years old (group 2). We analyzed the demographic, clinical and histological features of the groups and performed univariable and multivariable Cox regression analyses to evaluate predictors associated with survival. Results Median ages of patients were 35.5 years and 82 years in group 1 (n = 90) and group 2 (n = 55), respectively. Radical nephrectomy rate was statistically higher in group 2 (p = 0.004). Median follow-up was 72 (11-192) months in group 1 and 30 months (5-103) in group 2 (p < 0.001). The 5-year (90.2% vs. 80.2%) and 8-year (84.8% vs. 60.2%) overall survivals (OS) of the groups were statistically different (p < 0.001). Patients in group 1 demonstrated a 5 and 10-year cancer-specific survival (CSS) of 90.2% and 84.7%, whereas these rates were 82.4% and 54.9% for group 2 (p < 0.05). We found that higher hemoglobin drop (HR: 1.497), presence of sarcomatoid differentiation (HR: 4.307), high-stage disease (HR: 2.704), and metastasis detected in the follow-up (HR: 12.805) were independent risk factors that shortened OS (p < 0.05). Conclusion Sporadic RCC was associated with a more favorable CSS and OS in young adults compared to the octogenarians. Although two border-age groups had similar pathologies, they have different prognosis and survival rates.

Objective: Anxiety level in prostate cancer patients is common due to the increase in the incidence of prostate cancer diagnosis. We aimed to search for answers to the following questions such as whether there is preoperative anxiety in patients who will be operated for prostate cancer, what are the risk factors that may cause disease-induced anxiety and the type of surgery especially does robotic surgery reduce patient anxiety. Method: The patients who were taken into operation were divided into 2 groups as Open Radical Retropubic Prostatectomy-Group 1 and Robot-Assisted Laparoscopic Radical Prostatectomy-Group 2. Age, active surveillance history, preoperative prostate spesific antigen (PSA) level, prostate biopsy pathology result, time between prostate biopsy and operation, state and trait anxiety scores of these patients were recorded. Result: The study was conducted with a total of 149 patients; 61 patients in Group 1 and 88 patients in Group 2. The presence of active surveillance history, time between prostate biopsy and operation and state and trait anxiety levels were not found to be significant between both groups. However, it was concluded that the patients in Group 2 were significantly younger and operated with lower PSA and Gleason scores. The type of surgery had no effect on anxiety levels. Conclusion: Preoperative information about the surgical procedure was found to be an effective factor in reducing anxiety. Regardless of the type of surgery we recommend that patients’ anxiety should be reduced by explaining the surgical procedure to patients enough and in a way that they can understand.

Objective: Hydronephrosis, which may be caused by kidney stones in the collecting system, may induce permanent flank pain and damage to kidney function. In this study, we aimed to examine whether the presence of hydronephrosis in the patient has an effect on the stone-free rates in flexible ureterorenoscopy (FURS) applications. Method: The study was carried out retrospectively with 164 patients. Stone size was calculated as volume in computed tomography. Preoperative patient demographic data, radiographic stone characteristics, operational findings, complication status and postoperative 1st month results were recorded. Result: The mean stone-free rate was found to be 61.5%. It was determined that age, gender, side, number, size and the Hounsfield Unit of the stone, the presence of preoperative extracorporeal shock wave lithotripsy (ESWL) history and the presence of hydronephrosis and its degree did not affect the stone-free rate. However, it was concluded that preoperative percutaneous nephrolithotomy (PNL) application and prolonged operation time were found to affect statistically significant stone-free rate. In addition, ‘2’ was found to be the cut-off value for hydronephrosis in the receiver operating characteristic analysis. Conclusion: The presence of preoperative hydronephrosis does not decrease the success of FURS. However, it can be expected that the success of FURS will decrease as grade 2 or more severe grade of hydronephrosis. Therefore, we think that other treatment modalities such as ESWL and PNL should be prioritized in patients with grade 2 and more severe grade of hydronephrosis.

Objective To investigate the use of hematological parameters in the differential diagnosis of testis torsion and epididymo-orchitis, and to determine the predictive value of these parameters in the diagnosis of testis torsion. Methods This study retrospectively reviewed the medical data of patients who presented to our institute with the complaint of acute scrotal pain. Eighty-five patients who had undergone orchiectomy or surgical detorsion due to testis torsion and 72 patients with epididymo-orchitis were included in the study. The control group comprised 78 healthy males. The groups were compared with respect to age, hematological parameters, neutrophil to lymphocyte ratio (NLR), monocyte to eosinophil ratio (MER), and platelet to lymphocyte ratio (PLR). Results The monocyte count significantly differed between testis torsion and epididymo-orchitis, and was useful in the differential diagnosis. The mean neutrophil, platelet, and white blood cell counts, and the NLR, MER, and PLR values in the control group were significantly lower than those in the torsion and epididymo-orchitis groups. Conclusion The sensitivity and specificity of NLR in predicting testis torsion were as high as the sensitivity and specificity of doppler ultrasonography, suggesting the possible use of this parameter in the diagnosis of testis torsion.

Objective:The aim of this study is to determine whether previous open stone surgery is a risk factor for bleeding in patients undergoing percutaneous nephrolithotomy (PNL).Materials and Methods:Data of patients who underwent PNL in our clinic between 2007 and 2015 were reviewed retrospectively. Eighty-two patients underwent PNL and had a history of previous ipsilateral open surgery. A control group was created with 82 patients randomly selected among PNL patients with no history of open surgery. The groups were evaluated in terms of preoperative demographic data, operative success and complications, especially hemorrhage requiring transfusion.Results:The groups were similar in terms of demographic data and stone burden. One patient of each group was administered intraoperative blood transfusion. There was no statistically significant difference between the two groups in terms of postoperative blood transfusion (p=0.245).Conclusion:In our study, it can be said that previous open stone surgery does not increase potential complication of bleeding in PNL.

Percutaneous nephrolithotomy (PNL) is recognized as the gold standard treatment method for stones larger than 2 cm due to its high success and acceptably low complication rates. The complications of PNL are well defined. Prolonged urinary leakage is one of them. In this study, a case of post-PNL urine leakage that was eventually treated with nephrectomy is discussed.