Renal schwannomas are exceedingly rare benign tumors originating from Schwann cells, with fewer than 50 cases reported in the literature. The “ancient” variant refers to long-standing schwannomas that develop degenerative changes, which may mimic the aggressive radiological features of renal cell carcinoma. This diagnostic overlap often leads to preoperative misdiagnosis and can significantly impact surgical decision-making, often resulting in radical rather than nephron-sparing approaches. A 48-year-old White woman presented with a 3-month history of intermittent left flank discomfort. Imaging demonstrated a 6-cm complex cystic mass at the upper pole and hilum of the left kidney, characterized by thickened, enhancing septations (up to 7.5 mm) and a 13-mm mural nodule, consistent with a Bosniak IV cystic renal mass. No metastases were detected. Owing to the high suspicion of cystic renal cell carcinoma and the complex hilar location, she underwent laparoscopic left radical nephrectomy. Histopathological evaluation revealed a spindle cell neoplasm with Antoni A and B patterns and extensive degenerative changes, including hemorrhage and calcification, confirming a diagnosis of ancient schwannoma. Immunohistochemistry showed strong, diffuse S-100 positivity and SOX10 expression. At 12-month follow-up, the patient remained asymptomatic and disease-free. Ancient renal schwannomas pose substantial diagnostic challenges as they frequently masquerade as renal malignancies on imaging. While definitive diagnosis currently relies on histopathological analysis, maintaining awareness of this rare entity is important when evaluating complex cystic renal masses. Greater diagnostic awareness may help inform surgical planning and, in selected cases, allow consideration of nephron-sparing approaches.

BACKGROUND:The European Association of Urology (EAU) recommends transperineal biopsy (TPBx) due to its lower infection risk and higher diagnostic rate for anterior zone tumors. This study aims to assess the learning curve of TPBx using the Perino-Flex® angle-adjustable needle guide under local anesthesia. METHODS:A retrospective observational analysis was conducted from November 2023 to March 2024, involving 100 patients who underwent TPBx with coaxial technique under local anesthesia. Data collected included patient demographics, procedure and room times, pain levels, anxiety scores, and complications. The study focused on comparing procedure times, pain scores, and complication rates to evaluate the learning curve over time. RESULTS:The mean room time significantly decreased from 29.55 min in the first group to 19.95 min in the fifth (p < 0.001). Procedure time was reduced from 15.25 min in the first group to 7.50 min in the fifth (p < 0.001). Visual Analog Scale (VAS) scores during core sampling demonstrated a significant decrease after the first 20 patients (2.70 vs. 0.90 in the first and second quartile, respectively, p < 0.001), indicating a rapid gain in operator proficiency. When splitting the first 20 patients into two subgroups, pain scores significantly dropped after the initial 10 cases. Cancer detection rates remained stable across all groups. Notably, no infectious complications were observed throughout the study. CONCLUSION:This study highlights the learning curve for TPBx with an adjustable needle guide under local anesthesia. It shows that as experience grows, pain decreases and procedure times shorten, improving both patient comfort and efficiency. These findings offer valuable guidance for new practitioners to learn more quickly and achieve better diagnostic results.

Objective:To evaluate whether the systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and De-Ritis ratio (DRR) are determinants of progression-free survival (PFS), recurrence-free survival (RFS) and overall survival (OS) in patients aged ≥ 70 years diagnosed with non-muscle invasive bladder cancer (NMIBC). Method:The study included 173 elderly patients diagnosed with NMIBC between January 2015 and March 2022. The clinical and pathological data of the patients were examined. Cox regression analysis was performed. Results:The patient's mean age was 75.6 ± 4.57 years. A statistically significant correlation was determined between higher mean NLR, PLR, and SII values and PFS (p = 0.04, p = 0.009, and p = 0.007, respectively) and OS (p = 0.001, p = 0.003, and p < 0.001, respectively). The multivariate analysis results showed that tumor size (≥ 3 cm) and PLR (> 144.6) were independent risk factors for PFS (HR: 2.09, p = 0.03; HR:3.2, p = 0.01, respectively), the presence of multiple tumors for RFS (HR: 1.73, p = 0.01), and comorbid diseases for OS (HR: 2.18, p = 0.006). Conclusion:Inflammatory parameters were found to have no independent effects on RFS and OS in patients of advanced age with NMIBC, and only PLR could be used to predict PFS.

OBJECTIVE:A combination of local anesthetic treatments provides better pain alleviation than periprostatic nerve block (PPNB) alone during a prostate biopsy procedure. The primary objective of this study was to compare Visual Analog Scale (VAS) pain levels during transrectal ultrasound (TRUS)- guided prostate biopsy whilst the use of prilocaine-lidocaine cream, diclofenac suppository, or PPNB only in a prospective, randomized study. METHODS:This study included 162 patients who had TRUS-guided prostate biopsies performed at the Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Center within a 6 month period, from April to October 2017. Three groups of patients were randomly assigned: group 1 underwent PPNB plus prilocaine-lidocaine cream, group 2 received diclofenac suppository along with PPNB, and group 3 underwent PPNB alone. The VAS was used to measure the degree of pain: VAS 1 was used to record the pain at the time the ultrasound probe was inserted, VAS 2 was used to document the pain during PPNB, and VAS 3 was used to record the pain during needle biopsy. Following the biopsy, any complications or negative consequences were recorded. RESULTS:Mean age or serum prostate specific antigen (PSA) levels were similar between the three groups. The VAS 1, VAS 2, and VAS 3 pain scores showed statistically significant difference among the three groups (p=0.001). Between groups 1 and 2, there was a statistically significant difference in VAS 1 pain scores (p=0.01). There was no statistically difference in VAS 2 and VAS 3 pain scores between the groups 1 and 2 (p=0.08 and p=0.23, respectively). Patients between the groups 3 and other groups had significantly difference in VAS pain scores (p<0.05). CONCLUSION:In this study, we highlight that when applied as an adjuvant to PPNB, either 5% prilocaine-lidocaine cream or a 100 mg diclofenac suppository reduced pain levels relative to PPNB alone. When compared to a 100 mg diclofenac suppository, prilocaine-lidocaine cream significantly reduces pain during the insertion and manipulation of the ultrasound probe.

This study aimed to evaluate perioperative complications and oncologic results for high-risk and oligometastatic prostate cancer patients. The data of patients who underwent surgery for prostate cancer in the authors’ clinic between January 2012 and March 2022 were analyzed retrospectively. According to D’amico classification, 28 patients with high-risk prostate cancer and 23 patients in the oligometastatic stage were included in the study. The patients were divided into two groups: group 1 (high-risk prostate cancers) and group 2 (oligometastatic cancer). Demographic characteristics, oncologic data, pathologic data, and complications of the patients were recorded. The mean age of the patients was 67.84 years (range, 52–79 years). The average follow-up period was 45.48 months for group 1 and 46.36 months for group 2 (p = 0.84). The mean hemoglobin decrease was 1.53 g/dL in group 1 and 0.69 g/dL in group 2 (p = 0.046). Five patients (17.8

ObjectiveTo investigates the efficacy of formalin disinfection of the needle tip in transrectal prostate biopsy (TRB) procedure to reduce infectious complications. The primary aim is to assess the impact of formalin on bacterial contamination of biopsy needle tip and its association with post-biopsy infective events.Materials and MethodsWe have employed a bacterial culture-based observational cohort design in this study. Two groups, formalin disinfection and non-formalin group, both undergone systematic 12-core TRB. In the formalin group, the biopsy needle tip was immersed in 10% formalin solution after each core, while in the non formalin group no formalin solution immersion was used. The primary outcomes include bacterial growth on biopsy needle tips and post-biopsy infective events.ResultsFormalin disinfection significantly reduced bacterial growth on needle tips (p<0.001). The formalin group had no post-biopsy infections or sepsis, while the non-formalin group experienced a 7.5% infective event rate after TRB.ConclusionFormalin disinfection of biopsy needle tip significantly reduces bacterial growth on biopsy needle and urinary tract infectious complications developed secondary to TRB. Further multicenter randomized controlled studies with larger cohorts are warranted to validate and establish formalin disinfection as a routine practice in TRB procedures.

Objective: To determine clinically significant prostate cancer (csPCa) detection rate by combining the prostate-specific antigen density (PSAD) and prostate imaging-reporting and data system (PI-RADS) scores. Study Design: Descriptive study. Place and Duration of the Study: Department of Urology, University of Health Sciences, Ankara Oncology Training and Research Hospital, from January 2018 to April 2023. Methodology: Patients who underwent prostate biopsies after multiparametric magnetic resonance imaging (mpMRI) were included in the study. PI-RADS 4 and 5 lesions were considered as MR positive. The cut-off values for PSAD were also determined to evaluate csPCa. csPCa detection rates were evaluated by grouping the patients based on the PSAD and mpMRI findings. Results: PSAD cut-off value of 0.165 ng/mL/mL (sensitivity 80%, specificity 72%) was detected to predict csPCa (AUC = 0.81, 95% CI:0.756-0.866, p<0.001). csPCa detection rate was low (3%) in patients who have low PI-RADS scores (1-3) and a PSAD <0.165 ng/mL/mL. On the other hand, csPCa detection rate was high (50.5%) in patients who have a high PI-RADS score (4-5 lesions) and with a PSAD >= 0.165 ng/mL/mL. Conclusion: csPCa detection rates are low in patients with PI-RADS 1-3 lesions and low PSAD values. Unnecessary biopsy may be avoided in these patients.

Objectives: This retrospective study aimed to evaluate the prognostic importance of 18 F-fluorodeoxyglucose ( 18 F-FDG)-positive pelvic lymph nodes (LNs) and extra-pelvic disease on staging 18 F-FDG positron emission tomography/computed tomography (PET/CT) in patients with bladder cancer.Methods: Bladder cancer patients who underwent staging 18 F-FDG PET/CT were included in the study.Histopathologic features of tumors, therapy histories, presence of distinguishable tumors on CT and PET images, sizes and maximum standardized uptake value (SUV max ) of primary tumors, total numbers, sizes, and SUV max of 18 F-FDG-positive pelvic and extra-pelvic LNs, and total numbers and SUV max of distant metastases (M1a/1b) were recorded.Patients were followed up until death or the last medical visit.Factors predicting overall survival were determined using Cox regression analysis.Results: Fifty-five patients [median age: 70 (53-84), 48 (87.3%) male, 7 (12.7%)female] with bladder cancer were included in this study.Twentynine (52.7%) patients had 18 F-FDG positive pelvic LNs, while 24 (43.7%)patients had 18 F-FDG positive extra-pelvic disease.Patients with 18 F-FDGpositive pelvic LNs had a higher rate of extra-pelvic disease (p=0.003).The median follow-up duration was 13.5 months.The median overall survival was 16.3 months [95% confidence interval (CI) 8.9-23.7].The primary tumor distinguishability on PET (p=0.011) and CT (p=0.009)images, the presence of 18 F-FDG-positive pelvic LNs (p<0.001) and 18 F-FDG-positive extra-pelvic disease/distant metastases (M1a/M1b) (p<0.001), and the number of distant metastases (p=0.034) were associated with mortality.The 18 F-FDG-positive extra-pelvic disease/distant metastases [p=0.029,odds ratio: 4.15 (95% CI 1.16-14.86)]was found to be an independent predictor of mortality in patients with bladder cancer. Conclusion:The presence of 18 F-FDG-positive extra-pelvic disease in pretreatment 18 F-FDG PET/CT is an important prognostic factor in bladder cancer patients.

Background: Social platforms such as YouTube have become sources of information about diseases as they can be easily and rapidly accessed. However, this also has the risk of ill-intentioned content and misleading information.Objective: To evaluate the reliability of YouTube video content about delayed ejaculation treatment.Material and methods: YouTube videos were searched using the terms "delayed ejaculation," "retarded ejaculation," "inhibited ejaculation," and "anejaculation." Videos were excluded if they were not in English, were not related to the subject, or did not have audio and visual content. In accordance with the scientifically proven accurate information, the videos were separated as reliable (Group 2, n: 112) and unreliable videos (Group 1, n: 94). The groups were compared in respect of the video characteristics, and the scores obtained in the DISCERN-5, Global Quality Scale, the Patient Education Materials Assessment Tool Audiovisual, and the Journal of the American Medical Association scales. Intraclass correlation test was used to evaluate the level of agreement between the two investigators.Results: Of the 1200 videos, 994 were excluded. No significant difference was determined between the Group 1 and Group 2 in respect of the median number of views [1672 (4555) vs 1547 (28,559), p = 0.63] and likes [10 (42) vs 17 (255), p = 0.07]. There was a greater number of videos in the Group 2 (54.4%) and the points obtained on the scoring scales were significantly higher than the Group 1 (p < 0.001). The videos originating from universities/professional organizations/non-profit physician/physician group were comprised the majority of the reliable videos (55.3%) and the unreliable videos had more content related to treatment (71.4%) (p < 0.001).Conclusion: Although there was a greater number of reliable videos related to the problem of delayed ejaculation, the content could be misleading and should be avoided by patients seeking treatment without consulting a physician.

Objective: To conduct a translation and validation study of the Chronic Orchialgia Symptom Index (COSI), which has 12 questions in three domains pain (P), sexual symptoms (SS), and quality of life (QoL), in the Turkish language. Material and methods: The study included a total of 175 patients diagnosed with chronic scrotal content pain (CSCP) between January 2023 and January 2024. In addition to demographic data, the scores obtained on the COSI questionnaire and Visual Analog Scale (VAS) were recorded. Internal consistency was assessed using Cronbach alpha coefficients. Reliability was evaluated using the test-retest correlation method. Results: The mean age of the patients was 37.2 ± 14.1 years and the median (IQR) duration of pain was 5.5 (9) months. The median total COSI score was determined as 13 (13) and the median subscores were 7 (7) for P, 1 (2) for SS, and 5 (6) for QoL. The test-retest correlation coefficient for each item was determined to be higher than r = 0.80 ( p < 0.001). The Cronbach alpha values for the subscores were 0.80 for P, 0.71 for SS, and 0.80 for QoL. There was determined to be a statistically significant positive correlation between the VAS score and the COSI P, SS, QoL, and total scores ( r: 0.63, p < 0.001; r = 0.32, p < 0.001; r = 0.56, p < 0.001; r = 0.59, p < 0.001, respectively). The optimal cutoff point of the COSI total score was determined to be 16.5 points (AUC:0.77, p < 0.001) for the determination of patients experiencing severe pain (⩾ 7.5) according to the VAS score. Conclusion: The Turkish version of the COSI questionnaire is a valid, reliable, and repeatable questionnaire that can be used to evaluate the effects of symptom severity in patients with CSCP.

OBJECTIVES:To investigate the association between pain and sleep quality, anxiety, depression, body perception, and biological rhythm in chronic scrotal pain (CSP). MATERIAL AND METHODS:This cross-sectional study of 140 CSP patients was conducted between January and October 2023. The patients were separated into groups according to the Visual Analogue Scale (VAS) score as group 1 (score<3, n=27), group 2 (score: 3-6, n=84), and group 3 (score>6, n=29). In addition to demographic data, the points were recorded from the Body Image Scale (BIS), Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), Hospital Anxiety and Depression Scale (HADS), and the Pittsburgh Sleep Quality Index (PSQI). RESULTS:The median (IQR) age of patients was 33 (20) years and the median (IQR) duration of pain was 5 (9) months. Group 3 patients had more anxiety (24.1% vs. group 1: 22.2%; group 2: 8.3%; P=0.03) and depression (55.2% vs. group 1: 40.7%; group 2: 29.8%; P=0.04) symptoms. No statistical differences were determined between the groups according to the BIS (P=0.54). The median (IQR) total BRIAN score was higher in group 3 than group 1 [37 (11) vs. 33 (13), P=0.03]. Higher rates of poor sleep quality were determined in group 3 patients according to the PSQI (75.9% vs. group 1: 48.1%; group 2: 51.2%; P=0.04). The VAS score was found to be positively associated with pain duration, total BRIAN score and PSQI score (r=0.31, P<0.001; r=0.17, P=0.04; r=0.23, P=0.006, respectively). The PSQI score was found to be an independent predictor for a higher VAS score (HR: 1.14, P=0.01). CONCLUSION:The results of this study suggest that poor sleep quality may influence the perceived intensity of pain. LEVEL OF EVIDENCE:II.

Introduction: Kidney tumors have an important place among urological malignancies. The increased utilization of imaging methods has led to a rise in renal cell carcinoma (RCC) diagnoses, albeit with declining mortality rates, particularly in developed countries. Radical nephrectomy remains the gold standard treatment. The aim of this study was to share a tertiary oncology hospital's initial experiences with laparoscopic nephrectomy. Materials and methods: This retrospective study analyzes data from patients who underwent laparoscopic nephrectomy, focusing on demographic characteristics, tumor features, and operative outcomes. Information regarding age, gender, tumor size, operative details, and pathology results was collected and analyzed. Results: One hundred forty-two patients were included in the study; 69 (48.60%) were female and 73 (51.40%) were male. The mean age of the patients was 57.11 +/- 12.6 years, with tumors primarily located on the left kidney (52.80%). The mean tumor size was 53.01 +/- 24.01 mm. Intraoperative complications included the need for conversion to open surgery in five cases and vascular, pneumothorax, or duodenal injuries in a subset of patients. However, postoperative complications, such as sepsis or mortality, were not observed. Discussion: Despite an initial learning curve associated with longer operation times, laparoscopic techniques offer benefits, including reduced blood loss, faster recovery, and improved cosmetic outcomes. Histologically, clear cell RCC was the most common tumor type encountered. This study underscores the safety and efficacy of laparoscopic radical nephrectomy, advocating for its widespread adoption while emphasizing the importance of surgeon experience and patient selection in optimizing outcomes.

Abstract. Background. The objective of this study is to determine the role of tumor marker density (TMD) values such as alpha-fetoprotein tumor volume ratio (ATVR), beta-human chorionic gonadotropin tumor volume ratio (βTVR), alpha-fetoprotein testicle size ratio (ATSR), beta-human chorionic gonadotropin testicle size ratio (βTSR), lactate dehydrogenase tumor volume ratio (LTVR), and lactate dehydrogenase testicle size ratio (LTSR) in the determination of progression-free survival (PFS) in patients with testicular cancer. Materials and methods. A retrospective study was conducted of 95 patients followed-up in our clinic with a diagnosis of testicular cancer between January 2015 and August 2022. Patients were grouped according to clinical stage, as either early stage (n = 50) or advanced stage (n = 45). Clinical and pathological data and TMD values for all patients were recorded. Results. The median age of patients was 35 years (21–63 years). All TMDs except LTVR in advanced stage patients were found to be significantly higher than those of early stage patients (p < 0.05). Median ATVR (2.58 vs. 0.0), ATSR (0.63 vs. 0.03), βTVR (0.9 vs. 0.009), and βTSR (0.18 vs. 0.007) of the nonseminoma patients were found to be significantly higher than those of the seminoma patients, respectively (p < 0.001). Progression-free survival (months) was decreased in seminoma patients with high values of βTVR (11.3 ± 1.9 vs. 35.2 ± 0.7), βTSR (16.2 ± 3.4 vs. 35.2 ± 0.75), LTVR (17.7 ± 3.4 vs. 35.2 ± 0.7), and LTSR (21.5 ± 3.13 vs. 35.09 ± 0.8) (p < 0.001). Decreased PFS (months) was associated with higher values of ATVR (5.37 ± 0.7 vs. 35.05 ± 0.93), βTVR (7.4 ± 1.5 vs. 34.6 ± 1.3), ATSR (5.37 ± 0.75 vs. 35.05 ± 0.9), βTSR (7 ± 1.5 vs. 34.6 ± 1.3), and LTSR (7.9 ± 1.2 vs. 34.3 ± 1.5) in nonseminoma patients (p < 0.001). Based on multivariate analysis, βTVR-LTVR and ATVR-ATSR were determined to be independent risk factors for reduced PFS in seminoma and nonseminoma patients, respectively (p < 0.05). Conclusions. The results of this study suggest that the calculation of TMDs could be a promising and simple method for prediction of PFS among testicular cancer patients.

To determine the effect of heparin administered during the early post urethral trauma period on inflammation and spongiofibrosis in rats. The study included 24 male rats that were randomized into 3 groups of 8 each. The urethra was traumatized using a 24-G needle sheath in all rats. Group 1 (control group) received intraurethral saline 0.9% injected b.i.d. for 27 days, group 2 received intraurethral Na-heparin (liquemine-Roche) 1500 IU kg−1 injected b.i.d. for 27 days, and group 3 received intraurethral Na-heparin 1500 IU kg−1 injected b.i.d and saline 0.9% s.i.d. for 27 days. On day 28 the rats’ penises were degloved and penectomy was performed. Inflammation, spongiofibrosis, and congestion in the urethra were investigated in each group. A statistically significant difference was found between the three groups (control, heparin, and heparin + saline) in the histopathological status of spongiofibrosis, inflammation, and congestion, respectively (P = 0.0001, P = 0.002, P = 0.0001). Severe spongiofibrosis was observed in six (75%) of the rats in group 1 (control group), whereas severe spongiofibrosis was not observed in group 2 (heparin) or group 3 (heparin + saline). We observed that intraurethral Na-heparin 1500 IU kg−1 injectioned during the early posturethral trauma period in rats significantly decreased inflammation, spongiofibrosis, and congestion.

OBJECTIVE: In this study, we aimed to predict the changes in postoperative spermiogram parameters in patients who underwent varicocelectomy by using pre- and post-operative hemogram parameters and inflammatory blood markers. MATRERIAL and METHODS: 25 patients who underwent microscopic varicocelectomy in our clinic and met the study criteria were included in the study. Hemogram parameters were measured just before and twenty (20) days after the surgery, and spermiogram parameters were measured 6 months after the surgery. The patients seperated into two groups. Patients with >50% improvement in postoperative Total Motile Sperm Count (TMS) were included in the recovered patients group, and patients with less than 50% improvement were included in the non-recovered patients group. Neutrophil / lymphocyte ratio (NLR), platelet / lymphocyte ratio (PLR), monocyte / eosinophil ratio (MER), and blood counts such as neutrophil, lymphocyte, platelet, monocyte, eosinophil were compared in groups, also were compared before and after surgery, separate RESULTS: Improvement in TMS was observed in patients with a statistically significant decrease in postoperative NLR (p = 0.009; p <0.01). As a result of the calculations, cut-off point for the NLR change was accepted as 1.06% and above. PLR and MER parameters were not statistically significant in predicting the improvement of TMS. Among the neutrophil, lymphocyte, platelet, monocyte, eosinophil counts, preoperative neutrophil and preoperative monocyte counts were found to be higher in patients with postoperative TMS improvement. Cut-off points for these preoperative neutrophil and monocyte counts were calculated as 3.77 and 0.47, respectively. In our study, we could not reach any statistically significant result for lymphocyte, eosinophil and platelet counts. CONCLUSION: Preoperative and postoperative results of NLR, neutrophil or monocyte counts can be used as a marker to predict improvement in TMS. Keywords: varicocele, NLR, PLR, MER, inflammation

Holmium laser enucleation of the prostate (HoLEP) surgery has been increasingly used in urology because of its advantages for benign prostatic hyperplasia (BPH) surgical treatment in recent years. But, there are insufficient data in literature about the true frequency of the incidental presence of prostatic adenoma within the bladder following HoLEP surgery. The case is here presented of a patient who underwent HoLEP surgery 5 years previously, then presented at our clinic with lower urinary tract symptoms. On ultrasonography, a suspicious 3×3 cm tumoral formation was determined within the bladder trigone. Cystoscopy was performed, and the freeform mass floating in the bladder was seen. The mass was excised with bipolar transurethral resection of the prostate. The pathology examination was reported as BPH. The current case demonstrates the need for surgeons to bear in mind that there could be incidental adenoma in patients with BPH who have not fully healed following HoLEP surgery.

AIM:To evaluate the value of transrectal shear-wave-elastography(SWE) to differentiate benign and malignant tissues in patients with suspected prostate cancer.MATERIALS AND METHODS:Between January and May 2019, the study was designed as a prospective clinical study. The SWE value of 504 cores measured before biopsy and the pathology result of each core were used in the statistical analysis. The SWE values of benign and malignant cores were compared according to pathology results. ROC analysis was used to calculate the best cut-off SWE value for differentiating malignancy from benign tissues. Specificity, sensitivity, negative, and positive predictive values (NPV, PPV) were also calculated for cut-off value.RESULTS:Prostate cancer was detected in 74 (14.7%) of 504 core biopsies. The mean SWE values were found significantly higher in malignant cores (71.1 kPa) than benign cores (42.3 kPa) (p < 0.001). Cores with gleason score 7 had a significantly higher SWE value than Gleason score 6 (p = 0.009). The cut-off value to differentiate malignancy and area-under-curve were calculated 35.85 kPa, 0.733, respectively. The sensitivity, specificity, NPV, and PPV were 83%, 49%, 78%, and 95%, respectively for 35.85 kPa value.CONCLUSIONS:The malignant tissues have significantly higher SWE values. Also high gleason score was shown to be associated with high SWE values. To predict the prostate cancer, the difference of SWE values of between benign and malignant tissues has high sensitivity. In the near future, to prevent unnecessary prostate biopsies, SWE will be part of the standard protocol for prostate imaging.

To determine the active treatment option and perioperative complications using the 5-Factor Modified Frailty Index (mFI-5) in localized prostate cancer patients. Patients diagnosed with localized prostate cancer in our clinic between January 2018 and October 2022 were evaluated. The patients were separated according to the mFI-5 scores as Group 1 (score = 0, n = 74), Group 2 (score = 1, n = 41), and Group 3 (score ≥ 2, n = 69). Factors affecting the determination of treatment selection, oncological results, and surgical complications were identified with regression analysis. The mean age of the patients in Group 1 was lower than in Group 2 and Group 3 (63.09 ± 7.25 years vs. 67.56 ± 7.98 years and 69.2 ± 6.77 years, p < 0.001, respectively). In Group 1, more patients were treated with retropubic radical prostatectomy (RRP), and in Group 3 with radiotherapy (RT) and active surveillance (AS) (62.2

INTRODUCTION: We aimed to present the long-term oncological results of patients who underwent radical orchiectomy for testicular tumor. METHODS: The data of 150 patients who were admitted to our clinic with a preliminary diagnosis of testicular tumor and underwent inguinal radical orchiectomy between January 2010 and February 2022 were evaluated retrospectively. 141 patients whose pathology result was germ cell testicular tumor were included in the study. The primary aim of our study was to evaluate long-term survival outcomes. RESULTS: Eight (5.7%) of our patients had a history of cryptorchidism. Seventy-seven (54.6%) patients had tumors in the right testis, 58 (41.1%) patients had left testis, and 6 (4.3%) patients had synchronous or metachronous bilateral testicular tumors. Preoperative median AFP, ßHCG and LDH values of the patients were 3.6 ng/ml, 1.7 mIU/ml and 225 U/L, respectively. Postoperative median AFP and ßHCG values were 3.2 ng/ml and 0.1 mIU/ml, respectively. Fifty-fourpatients (38.2%) had lymph node involvement. The mean lymph node size was 2.32 cm. None of ourpatients had visceral organ involvement. During the mean follow-up period of 76 months, only 1 (0.7%) patient died due to testicular cancer. No death was observed in any of our patients due to any reason other than TC. DISCUSSION AND CONCLUSION: We can state that survival rates are high in centers where both surgical and medical/radiation therapy can be planned in coordination, even in patients with advanced testicular tumors.