Objective: This multicenter study aimed to evaluate postoperative partner education practices among Turkish urologists performing penile prosthesis implantation (PPI) and to assess their attitudes toward combined device training and sexual counseling. Material and Methods: A cross-sectional electronic survey was distributed to 164 urologists across the seven geographical regions of Türkiye, with 84 responses obtained (response rate: 51.2%). The 10-item questionnaire assessed: (i) demographic and procedural characteristics, (ii) current partner education practices, and (iii) discrepancies between beliefs and practices (using 5-point Likert scales). Results: The mean professional experience was 16 years (range: 2–35 years). Significant belief–practice gaps were identified: Device training was considered necessary by 81% of respondents but implemented by only 31% (50.6-point gap), while sexual counseling was considered necessary by 83% but implemented by only 19% (64-point gap). Significant associations were observed for device training (OR = 2.1) and sexual counseling (OR = 3.4). Senior surgeons (>10 years of experience) were 3.2 times more likely to prioritize partner education (OR = 3.2, 95% CI: 1.8–5.7). Conclusion: Although 72% of urologists endorsed partner education as “essential” substantial barriers to implementation remain. Particularly in sexual counseling, only 15% had received formal training. Institutional protocols and standardized training programs are urgently needed to bridge these gaps in postoperative PPI care.

Aim: Targeted prostate biopsies using magnetic resonance imaging (MRI) have gained prominence for early detection. We compared cognitive fusion biopsy, the most practical of these biopsy methods, with systematic prostate biopsy performed under transrectal ultrasonography (TRUS).Methods: Between August 2021 and August 2022, 81 patients who had never undergone prostate biopsy or surgery, with total prostate-specific antigen (PSA) levels between 4 and 20 ng/mL, and had lesions scoring 3 or above on the Prostate Imaging Reporting and Data System (PIRADS) on multiparametric MRI (Mp-MRI), were included in the study. Of these patients, 39 underwent standard TRUS-guided systematic prostate biopsy, while 42 underwent cognitive fusion biopsy (systematic + targeted).Results: The ages, PSA levels, and prostate volumes of the patients included in the study were compared, and no significant differences were found between the groups. The prostate cancer detection rate was 41% in the systematic biopsy group and 52.4% in the cognitive fusion biopsy group, but this difference was not statistically significant (p = 0.306). The detection rate of clinically significant prostate cancer was 25% in the systematic biopsy group and 63.6% in the cognitive fusion biopsy group, with this difference being statistically significant (p = 0.019). In the cognitive fusion biopsy group, 36.4% of patients with malignant biopsy results had no tumour at the targeted site, while 63.6% had tumours detected at the targeted site (p = 0.286).Conclusion: Cognitive fusion biopsy was found to be superior to standard TRUS-guided systematic prostate biopsy in diagnosing clinically significant prostate cancer. However, there was no difference between the two biopsy techniques in overall prostate cancer detection.Level of evidence: Not applicable

Objective: This study aims to evaluate the effectiveness, safety, and patient tolerance of penile prosthesis implantation (PPI) performed under local anesthesia (LA). The study investigates its impact on perioperative pain management, postoperative recovery, and overall patient satisfaction. Material and Methods: This prospective study included 26 male patients who underwent PPI under LA between January 2024 and December 2024. Ethical approval was obtained from the Ethics Committee Antalya Training and Research Hospital No: 2/24, Date: 30.01.2025). Pain intensity was assessed using the Visual Analog Scale (VAS), while patient stability and intraoperative parameters were monitored. The American Society of Anesthesiologists (ASA) classification system was used for anesthesia risk assessment. Results: The mean age of the patients was 67.25 ± 11.48 years. Diabetes mellitus and hypertension were present in 75% and 62.5% of patients, respectively. According to ASA classification, 46.2% were classified as ASA-II, while 53.8% were ASA-III. The mean intraoperative VAS score was 1.8 (mild pain), while the mean postoperative VAS score was 4.6 (mild-to-moderate pain). No patients required additional sedation or conversion to general anesthesia. No major intraoperative complications or postoperative prosthesis-related complications were observed. Conclusion: Local anesthesia is a feasible and effective alternative for penile prosthesis implantation, offering benefits such as minimal intraoperative discomfort, avoidance of systemic anesthetic complications, and a favorable recovery profile. Further studies with larger cohorts are needed to optimize pain management strategies and evaluate long-term functional outcomes.

OBJECTIVE: In this study, we aimed to investigate the factors affecting spontaneous stone passing in patients who received medical expulsive therapy due to distal ureteral stones. MATERIAL AND METHODS: From September 2022 to October 2023, a total of 148 patients with distal ureteral stones sized 4-10 mm were included. Patients received silodosin 4 mg as medical expulsive therapy and were followed up for a maximum of four weeks. The patient- and stone-related variables affecting spontaneous stone passage were evaluated. RESULTS: The mean age of the participants was 42.92±12.78 years. The stone expulsion rate was 64.2%. The rate of spontaneous stone passage was significantly higher in patients with lower stone size, stone burden, ureteral wall thickness, distance of the stone to the ureterovesical junction, neutrophil-lymphocyte ratio and hydronephrosis grade. (all, p<0.05). The distance of the stone to the ureterovesical junction, ureteral wall thickness, and neutrophil-to-lymphocyte ratio were independent predictors of spontaneous passage (p:0.036, p:0.001, p:0.001, respectively). CONCLUSIONS: The distance of stone to the ureterovesical junction, ureteral wall thickness, and neutrophil-to-lymphocyte ratio can be useful parameters to estimate spontaneous stone expulsion. These factors play important roles in decision-making for the management of distal ureteral stones.

Aim: To assess the oncological and functional outcomes of patients aged 70 years or older after robot-assisted radical prostatectomy (RARP) and compare their results with younger men. Materials and Methods: Our study included 496 men who underwent RARP in our clinic between March 2015 and December 2021 with at least 1-year follow-up. Of these patients, 130 were aged 70 or older, and 366 were between 60 and 69. Preoperative characteristics, perioperative parameters, postoperative oncological, and functional results were studied. Results: The entire cohort (496 patients) aged 67 years on median (range 60-84), with a median prostate-specific antigen of 8.4 ng/mL. All the patients had a minimum 1-year of follow-up and the median follow-up was 32 months. According to the perioperative parameters, the two groups were similar except for hospital length of stay. On final pathology, the pathological stage, positive surgical margin rate and lymph node positivity were statistically not different between the two groups. The International Society of Urological Pathology grades were higher on final pathology for both groups, but this increase was greater in the ≥70 age group, and this was statistically significant (P = .013). In both groups, the median International Index for Erectile Function scores decreased after surgery significantly (P < .001), and at the 1st year follow-up, the decrease between the two groups was not different (0.973). Concerning continence outcomes, pad-free continence was significantly better in the 60-69 age group (94.5%) compared to the ≥70 age group (93.1%). Conclusions: The perioperative safety, oncological, and functional results of RARP in elderly men are comparable to younger patients. Clinical trial registiration number: (30/06/2022-13/24).

Objective:The present study was aimed to determine the effect of penile pros-thesis implantation(PPI)surgery on penile sensation by evaluating the penile electromyog-raphy(EMG)variables. Methods:The research was designed as a prospective study.Thirty patients who were diag-nosed with organic erectile dysfunction and had underwent PPI surgery between January 2017 and January 2018 in the Urology Clinic of Antalya Training and Research Hospital were included in this study.Penile sensory EMG was performed on each patient 1 day prior to the surgery by the Physical Therapy and Rehabilitation clinic.Additionally,the control EMG study was also performed in the 3rd and 6th postoperative months. Results:We included 27 patients in this study who attended regular follow-ups and had com-plete EMG results.Out of the 27 patients,23(85.2％)patients had received malleable(ProMe-don)penile prosthesis,one(3.7％)patient had received a two-piece inflatable(Ambicor)penile prosthesis,and three(11.1％)patients had received a three-piece inflatable(AMS 700 CXR)penile prosthesis.The mean nerve conduction value(NCV)of the patients was 29.85(standard derivation:22.54;range:0-78.4)m/s during the preoperative period,whereas it was 27.64(standard derivation:24.72;range:0-83.3)m/s in the 3rd postoperative month and 24.80(standard derivation:22.31;range:0-88.4)m/s in the 6th postoperative month.There was no significant difference between preoperative NCV and 3rd postoperative month NCV(p=0.607).Similarly,no significant difference was observed between preoperative NCV and 6th postoperative month NCV(p=0.276).Additionally,the change between NCV values at postoperative 3rd and 6th months was not statistically significant(p=0.553). Conclusion:Significant loss of penile sensation does not occur in patients who undergo PPI sur-gery.

Purpose: The aim of this study is to investigate the effect of bladder neck plication during transperitoneal robot-assisted radical prostatectomy (tRARP) on orgasm-related incontinence (climacturia) and the relationship between International Index of Erectile Function 5 (IIEF-5) scores and climacturia.Materials and Methods: We evaluated 118 patients who underwent nerve-sparing tRARP in our clinic and survived the first postoperative year. Patients were divided into two groups: those who underwent bladder neck plication (Group 1, n = 58) and those who did not (Group 2, n = 60). Our study investigated whether there is a difference between the groups in terms of climacturia or if there is a relationship between IIEF-5 scores and climacturia.Results: Of the patients in Group 1, 10.3% had incontinence and 13.8% had climacturia. Of the patients in Group 2 who did not have bladder neck plication, 10% had incontinence and 15% had climacturia. There was no difference between the groups in terms of climacturia (P > .825). Three patients (5.2%) in Group 1 and four patients (6.6%) in Group 2 requested treatment. There was no statistically significant correlation between IIEF-5 scores and climacturia in both groups (Group 1, P > .208; and Group 2, P > .508).Conclusions: In our study, the frequency of climacturia in patients who underwent bladder neck plication during tRARP was consistent with the literature and did not show a statistically significant difference from patients who did not undergo bladder neck plication. It has been observed that bladder neck plication, which has no effect on long-term continence, does not contribute to prevention of climacturia. No correlation was found between IIEF-5 scores and climacturia.

Objective: The aim of this study is to determine whether there is a genetic predisposition in young patients with transitional cell carcinoma (TCC) of the bladder. Material And Methods: Data were collected from a total of 652 patients who underwent transurethral resection of bladder tumor (TUR-BT) between January 2010 and January 2021. Seven patients under the age of 40, non-smokers, and without occupational predisposing factors to urinary tract TCC were included in the study. Age, body mass index (BMI), sex, occupation, and five-year follow-up were collected retrospectively. A total of 403 cancer-related genes were analyzed from the patients’ blood samples. The Clinical Exome Sequencing test was used to identify genetic mutations. Results: Six of the patients were male and one patient was female. The mean age and BMI were 31.42 ± 2.12 (22-39) years and 21.72 ± 33.14 (22-27.7) kg/m2, respectively. None of the patients had a first-degree relative with urinary tract TCC. Of all the patients, only one patient had a deletion of exons 1 to 17 in the breakpoint cluster region gene. Conclusion: Genetic predisposing factors in young bladder TCC have not been clearly identified. Although our study included a limited number of patients, our results showed no genetic predisposition in young patients with bladder TCC without family history of bladder cancer. To evaluate the exact relationship, prospective randomised controlled trials with larger numbers of patients are needed.

Objective: To investigate the effect of tadalafil, used for treating erectile dysfunction (ED) at a daily dose of 5 mg for 12 weeks, on penile sensation.Materials and Methods: Our study included 30 male patients who applied to our andrology outpatient clinic with the complaint of ED and were prescribed tadalafil at a daily dose of 5 mg for 12 weeks. Before treatment, serum levels of testosterone and luteinizing hormone (LH) were measured. Demographic and clinical characteristics were recorded. Pre-and post-treatment electromyography (EMG) examinations for penile sensation and International Index of Erectile Function (IIEF-5) scoring were performed for each patient.Results: The mean age was 53 +/- 9 years. The mean body mass index was 27 +/- 2. Before treatment, serum levels of testosterone and LH were within the normal range. There were 8 (29%) patients with diabetes mellitus and 7 (25%) patients with hypertension. The pre-and post-treatment IIEF-5 scores were 13 +/- 3 and 19 +/- 3, respectively. Nerve conduction velocities (NCV) increased from 35.5 m/sec to 38.05 m/sec. Latency values decreased from 2.32 ms to 2.14 ms. There was a statistically significant improvement in IIEF-5 scores and EMG results for penile sensation after treatment (IIEF-5, NCV and latency; p<0.001, p<0.001 and p=0.001, respectively).Conclusion: In this study, we showed that tadalafil at a daily dose of 5 mg used for treating ED provides an increase in penile sensation.

INTRODUCTION:We aimed to present our experience of robot-assisted laparoscopic radical prostatectomy (RARP).MATERIAL AND METHODS:The study was a retrospective review of 500 patients who underwent RARP between March 2015 and July 2021 in our clinic. A transperitoneal approach was used in all patients. All patients had clinically organ-confined prostate cancer (≤ cT2c).RESULTS:The mean age of the patients was 64.6 ± 5.7 years. The median PSA was 11.4 ng/dL (range 0.3-92.7). The mean operative time was 183.5 min. Positive surgical margin rate was 19.4%. During a mean follow-up of 23.5 months, 96 patients (19.2%) received adjuvant radiotherapy due to the biochemical recurrence and 28 patients (16%) with lymph node positivity received early adjuvant hormone therapy. Considering the continence rates, 69% of the patients were total continence in the 3rd month, while this rate increased to 83 in the 6th month and 91% in the 12th month.CONCLUSION:RARP is a safe and feasible method for experienced centers with patient comfort, surgeon comfort, and successful oncological and functional results.

To describe the perioperative safety, functional and immediate post-operative oncological outcomes of minimally invasive RPLND (miRPLND) for testis cancer. We performed a retrospective multi-centre cohort study on testis cancer patients treated with miRPLND from 16 institutions in eight countries. We measured clinician-reported outcomes stratified by indication. We performed logistic regression to identify predictors for maintained postoperative ejaculatory function. Data for 457 men undergoing miRPLND were studied. miRPLND comprised laparoscopic (n = 56) or robotic (n = 401) miRPLND. Indications included pre-chemotherapy in 305 and post-chemotherapy in 152 men. The median retroperitoneal mass size was 32 mm and operative time 270 min. Intraoperative complications occurred in 20 (4%) and postoperative complications in 26 (6%). In multivariable regression, nerve sparing, and template resection improved ejaculatory function significantly (template vs bilateral resection [odds ratio (OR) 19.4, 95% confidence interval (CI) 6.5–75.6], nerve sparing vs non-nerve sparing [OR 5.9, 95% CI 2.3–16.1]). In 91 men treated with primary RPLND, nerve sparing and template resection, normal postoperative ejaculation was reported in 96%. During a median follow-up of 33 months, relapse was detected in 39 (9%) of which one with port site (< 1%), one with peritoneal recurrence and 10 (2%) with retroperitoneum recurrences. The low proportion of complications or peritoneal recurrences and high proportion of men with normal postoperative ejaculatory function supports further miRPLND studies.

Nephrometry scores are designed to characterize tumors and stratify the surgical complexity. It remains unclear as to which nephrometry score can accurately predict the surgical outcomes. We aimed to assess the utility of radius, exophytic/endophytic, nearness, anterior/posterior, location (RENAL), preoperative aspects and dimensions used for anatomic classifications (PADUA), and centrality index (C-index) nephrometry scores for predicting the strict Trifecta achievement from a single institution series robotic-assisted partial nephrectomy (RAPN). We retrospectively identified the prospectively maintained robotic surgery database records of 91 patients who underwent RAPN between June 2015 and September 2020 in Antalya Training and Research Hospital. The main outcome of the study was the achievement of strict Trifecta (negative surgical margin, no major urologic complications, warm ischemia time ≤25 min, and ≥85% preservation of estimated glomerular filtration rate). A multivariable analysis was performed to identify the factors of strict Trifecta success. The mean patient age was 55.82 ± 13.37 years with a median clinical tumor size of 3.5 cm (IQR 2.5–4.9). The median RENAL, PADUA, and C-index score were 7(IQR 6–8), 8(IQR 7–10), and 2.01(IQR 1.64–2.72), respectively. A strict Trifecta could be achieved in 54 patients (59.3%). Clinical tumor size (P = 0.011), RENAL risk groups (low:reference; intermediate; P = 0.040; high; P = 0.009), PADUA risk groups (low:reference; intermediate; P = 0.044; high; P = 0.001) and C-index risk groups (low:reference; high; P = 0.015) were the independent predictors of strict Trifecta attainment in the multivariate analysis. None of the nephrometry scores were a superior predictor compared to other nephrometry scores in comparative analysis. RENAL, PADUA, and C-index scores were all independent predictors of a strict Trifecta achievement. Our comprehensive comparison of the three scores identified that none of the nephrometry scores proved to be inferior to others nephrometry scores.

Background: The aim of the study is to examine the effect of peritoneal re-approximation or non-approximation on the postoperative course of patients at the end of transperitoneal robot-assisted radical prostatectomy (tRARP).It is also aimed to examine the relationship between peritoneal re-approximation or non-approximation and drain removal time, need for analgesics, passage of flatus, and length of hospital stay. Methods: A total of 247 patients who underwent tRARP by 2 different experienced surgeons were included in the study. At the end of the tRARP procedure, 1 surgeon performed peritoneal re-approximation (Group 1, n = 108), whereas the other performed peritoneal non-approximation (Group 2, n = 139). The effect of the procedures on drain removal time, passage of flatus, need for analgesics, and length of hospital stay were compared between the groups. Results: There was no significant difference between the groups in terms of preoperative parameters including age, body mass index, and preoperative prostate-specific antigen levels (P > .05) (P = .622, P = .126 and P = .591, respectively). No statistically significant difference was found between the two groups in terms of comorbidity, Gleason score, clinical stage, and lymph node dissection (P = .086, P = .344, P = .318, P = .587, respectively). There was no statistically significant difference between the groups in terms of drain removal time, need for analgesics, passage of flatus, and length of hospital stay (P = .095, P = .142, P = 95, P = .389, respectively). Conclusion: This study did not demonstrate any additional postoperative benefit of peritoneal re-approximation. It has been shown that peritoneal re-approximation has no effect on the length of hospital stay, the need for pain relievers, and passage of flatus, drain duration, day. Therefore, we do not recommend re-approximation of the peritoneum.

Abstract. Background:. To evaluate the changes in penile sensation by electrophysiological tests in patients who underwent radical prostatectomy (RP) and to demonstrate the role of dorsal penile nerve injury in postoperative erectile dysfunction. Materials and methods:. Twenty-six volunteer patients who were eligible for RP were included in the study. Preoperative penile sensory electromyography and the International Index of Erectile Function-5 (IIEF-5) questionnaire were done for each patient. Erectile function assessment and electrophysiological evaluation of penile sensation were repeated at postoperative 3rd and 6th months. Results:. Postoperative IIEF-5 scores and electromyography values were significantly lower than preoperative findings (p < 0.05). The IIEF-5 scores in the nerve sparing-RP (NS-RP) group were significantly higher than the non-nerve sparing-RP (NNS-RP) group in the postoperative period. Nerve conduction velocity values in the NS-RP group were also higher than the NNS-RP group at the postoperative 3rd and 6th months. However, these changes were not statistically significant (p > 0.05). Conclusions:. Patients who underwent RP have decreased penile sensation due to cavernous nerve damage and a possible dorsal penile nerve injury. The decrease of penile sensation may be associated with postoperative erectile dysfunction.

Objective:To report our experience with biopsy positive T0 prostate cancer (PCa) and perform a literature review to determine the frequency, clinical outcomes, and predictors of pT0 PCa after radical prostatectomy (RP).Materials and Methods:The records of 497 patients who underwent robot-assisted RP at our institution between 2015 and 2020 were retrospectively reviewed. No patients were diagnosed after the transurethral prostate resection or received preoperative hormone therapy. Clinicopathological features including age, prostate-specific antigen (PSA), body mass index, digital rectal examination, biopsy results, clinical T stage, D’Amico risk, prostate weight, prostatectomy pathology, and follow-up data were analyzed.Results:Overall, 3 patients were classified as pT0 on pathologic examination of the RP. The biopsy re-evaluation revealed that 1 patient did not have PCa. Subsequently, the entire RP specimens were re-analyzed, wherein 2 cases were signed out with no identified carcinoma. The incidence of the pT0 PCa was 0.4% in our series. The median age of patients was 64 years. The median PSA was 14.27 ng/mL. Biopsy Gleason score of 2 patients was reported as 3 + 3. All patients had a tumor in only one core and all were in clinical stage T1c. No biochemical recurrence was found in a mean 21-month follow-up. Eleven studies were identified involving 26,228 patients, wherein 122 (0.46%) were reported with pT0 cases. Most patients with stage pT0 have been reported to have a Gleason score of <7, only one positive core biopsy, and a tumor length of <2 mm.Conclusion:Patients with a Gleason score of 6 and tumors in a single core and length of <2 mm in the biopsy should be informed about the risk of stage pT0.

You have accessJournal of UrologyPenile & Testicular Cancer: Penile & Testicular Cancer II (PD53)1 Sep 2021PD53-05 EJACULATION AFTER ROBOTIC RETROPERITONEAL LYMPH NODE DISSECTION STRATIFIED BY INDICATION, SURGICAL TEMPLATE, AND NERVE SPARING Christian Fankhauser, Luca Afferi, Sean P. Stroup, Nicholas R. Rocco, San Diego, CA, Kathleen Olson, Aditya Bagrodia, Fady Baky, Walter Cazzaniga, David Nicol, Erik Mayer, Ekrem Islamoglu, Stephane de Vergie, Ragheed Saoud, Scott E. Eggener, Lee Hugar, Wade Sexton, Deliu-Victor Matei, Thomas Hermanns, Robert Hamilton, Andreas Hiester, Peter Albers, Noel W. Clarke, and Agostino Mattei Christian FankhauserChristian Fankhauser More articles by this author , Luca AfferiLuca Afferi More articles by this author , Sean P. StroupSean P. Stroup More articles by this author , Nicholas R. RoccoNicholas R. Rocco More articles by this author , San Diego, CASan Diego, CA More articles by this author , Kathleen OlsonKathleen Olson More articles by this author , Aditya BagrodiaAditya Bagrodia More articles by this author , Fady BakyFady Baky More articles by this author , Walter CazzanigaWalter Cazzaniga More articles by this author , David NicolDavid Nicol More articles by this author , Erik MayerErik Mayer More articles by this author , Ekrem IslamogluEkrem Islamoglu More articles by this author , Stephane de VergieStephane de Vergie More articles by this author , Ragheed SaoudRagheed Saoud More articles by this author , Scott E. EggenerScott E. Eggener More articles by this author , Lee HugarLee Hugar More articles by this author , Wade SextonWade Sexton More articles by this author , Deliu-Victor MateiDeliu-Victor Matei More articles by this author , Thomas HermannsThomas Hermanns More articles by this author , Robert HamiltonRobert Hamilton More articles by this author , Andreas HiesterAndreas Hiester More articles by this author , Peter AlbersPeter Albers More articles by this author , Noel W. ClarkeNoel W. Clarke More articles by this author , and Agostino MatteiAgostino Mattei More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002080.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Open retroperitoneal lymph node dissection (RPLND) is the standard of care in men with germ cell tumours and post-chemotherapy retroperitoneal residual disease. More recently, primary RPLND has re-emerged as a potential treatment option in stage 2 disease and as an adjuvant option in stage 1. The most frequent side-effect of RPLND is retrograde ejaculation but nerve-sparing, template resection and robotic surgery have been introduced to reduce this complication. The aim of this study was to describe ejaculatory function after robotic RPLND stratified by indication, surgical templates, and nerve sparing. METHODS: International, multicentre, retrospective cohort study describing patient characteristics, surgical template, nerve sparing and ejaculatory function after robotic RPLND. Ejaculation status was retrieved from medical charts. Logistic regression was performed to identify predictors for sustained post-operative ejaculatory function. RESULTS: Of 359 men undergoing robotic RPLND in 8 countries at 14 institutions, sufficiently detailed information regarding surgical templates, nerve sparing, and ejaculatory function was available in 255 (71%). Indications included primary RPLND in 185 including 4 with recurrence after one cycle of adjuvant chemotherapy for stage 1 disease and post-chemotherapy RPLND in 70. The median retroperitoneal mass size was 30mm (IQR 19-45). Median operative time was 282 minutes (IQR 212-349). Bilateral and modified templates were used in 119 and 136 respectively. Eight different modified templates were described. Nerve sparing was performed in 195 patients (76%). In multivariable regression, nerve-sparing and template resection improved ejaculatory function significantly (template vs bilateral resection [Odds ratio (OR) 19.4, 95% confidence interval (CI) 6.5-75.6], nerve sparing vs non-nerve sparing [OR 5.9, 95% CI 2.3-16.1]). There was a higher chance to maintain ejaculatory function in men undergoing primary compared to post-chemotherapy RPLND, although this difference failed to reach statistical significance (OR 1.8, 95% CI 0.8-4.0). In the overall cohort, ejaculation after RPLND was reported in 218 (85%) whereas in the subgroup of 75 men treated with primary RPLND, nerve sparing, and template resection, normal ejaculation was reported in 72 (96%). CONCLUSIONS: In this retrospective, international robotic RPLND cohort, template resection and nerve sparing improved post-operative ejaculatory function. From a functional perspective, the high proportion of men with normal ejaculation after primary RPLND with nerve sparing approaches supports further studies of surgery in men with stage 1 or 2 disease. However, long-term oncological follow-up is also required before RPLND can be recommended in early-stage testis cancer. Further studies should clearly define surgical templates and assess patient reported ejaculatory function prospectively. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e917-e918 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christian Fankhauser More articles by this author Luca Afferi More articles by this author Sean P. Stroup More articles by this author Nicholas R. Rocco More articles by this author San Diego, CA More articles by this author Kathleen Olson More articles by this author Aditya Bagrodia More articles by this author Fady Baky More articles by this author Walter Cazzaniga More articles by this author David Nicol More articles by this author Erik Mayer More articles by this author Ekrem Islamoglu More articles by this author Stephane de Vergie More articles by this author Ragheed Saoud More articles by this author Scott E. Eggener More articles by this author Lee Hugar More articles by this author Wade Sexton More articles by this author Deliu-Victor Matei More articles by this author Thomas Hermanns More articles by this author Robert Hamilton More articles by this author Andreas Hiester More articles by this author Peter Albers More articles by this author Noel W. Clarke More articles by this author Agostino Mattei More articles by this author Expand All Advertisement Loading ...

Amaç: Rektum kanserinin penise metastazı oldukça az görülen bir olgudur. Biz bu olgu sunumunda literatürde sınırlı sayıda bildirilmiş ve çok nadir bir olgu olan rektum kanserinin penise metastazı olgumuzu sunmayı hedefledik.Olgu : 70 yaşında erkek hasta tarafımıza akut üriner retansiyon ve penis üzerinde ağrılı ülsere lezyonlar ile başvurdu. Hastanın 3 sene önce rektum kanseri nedeniyle neoadjuvan kemoterapi ve ardından aşağı anterior rezeksiyon ameliyatı geçirdiği öğrenildi. Çekilen PET BT’ de pelvik bölgede nüks ve penis üzerinde metastastik nodüller görüldü. Penis üzerindeki nodüllerden alınan eksizyonel biyopside rektum kanserinin penise metastazı olduğu histopatolojik olarak anlaşıldı. Sonuç: Zengin kanlanmasına ve pelvik organlara yakınlığına rağmen, penis metastazı çok nadir görülür. Penise metastatik yayılımın mekanizması tam anlaşılamıştır. Çok kötü prognozludur ve literatürde penis metastazı tedavisi için yeterli veri yoktur. Tedavide palyatif tedaviler sağkalım faydaları olsun veya olmasın düşünülmelidir.

Aim: To report the demografics, operative and postoperative outcomes of laparoscopic partial nephrectomy (LPN) in T1a/T1b stage renal tumors. Matherials and Methods: In total of 60 patients were evaluated, retrospectively who underwent LPN with a normal contralateral kidney, between May 2015 and October 2018. Demographics, perioperative and postoperative outcomes were evaluated and discussed with the literature. Result: 42 patients were included in the study. The mean age, tumor size and RENAL scores were 60.52 (± 10.51) years, 3.58 (± 1.55) cm and 6.548 (± 1.17), respectively. The duration of warm ischemia time was 26,88 (± 6,27) minutes. The mean operative time, estimated blood loss, length of hospital stay time were 162.26 (± 38.97) min, 166.79 (± 98.32) mL and 3.45 (± 0.89) days, respectively. Preoperative and postoperative estimated glomerular filtration rate (eGFR) were 76.83 (± 18.36) and 71.93 (± 20,12) mL/min/1.73 m2, respectively. eGFR decrease was 4.9 (6.38%) mL/min/1.73 m2 at the 3 months postoperative. The rate of postoperative complications, surgical margin status and eGFR decrease were similer to literature. The mean follow-up time was 21.02 (± 13.26) months. Conclusion: Although LPN has long learning curve, it is a safe PN method that can be applied in selected renal tumor cases with excellent oncological and functional results with acceptable complication rates.

Port-site metastasis (PSM) have gained importance due to increasing number of robot-assisted radical cystectomy (RARC). To the best of our knowledge, there are 13 cases in the literature, with only one reporting, treatment modality and oncological outcome. There is no consensus about the treatment for PSM developing after RARC. Here, we report a PSM occurring in the early period after RARCand recommend a treatment modality.