BACKGROUND:Three-piece penile prosthesis implantation (PPI) is the gold standard treatment for refractory erectile dysfunction. Although infection rates have declined with improved surgical techniques and antibiotic prophylaxis, postoperative hematoma remains an early complication that may predispose to infection and device malfunction. The role of short-term closed-suction drainage in reducing these complications remains controversial. AIM:To evaluate whether placement of a 24-h closed-suction drain reduces postoperative hematoma, infection, and mechanical complications following primary three-piece PPI surgery. METHODS:This retrospective comparative study included 410 patients undergoing primary penoscrotal three-piece PPI between September 2020 and August 2024. Patients were divided into a drain group (n = 149) and a no-drain group (n = 261). Demographics, comorbidities, operative characteristics, and postoperative outcomes were analyzed. Hematoma was assessed clinically and by ultrasonography on postoperative days 3 and 10. Patients were followed for 12 months. Comparative and multivariate statistical analyses were performed. OUTCOMES:Primary outcomes: Postoperative hematoma and infection.Secondary outcomes: Mechanical complications and risk factors associated with hematoma formation. RESULTS:On postoperative day 3, hematoma was detected in 13.4% of the drain group and 8.8% of the no-drain group (P = .143). By day 10, rates were 16.8% and 13.0%, respectively (P = .298). Infection occurred in 2.0% of patients overall, with no difference between groups (P = 1.000). Mechanical complication rates were also comparable (2.7% vs. 4.2%, P = .427). Hematoma formation was significantly associated with infection (postoperative day 3, OR: 29.0; P < .001; day 10, OR: 10.6; P = .002) and prosthesis malfunction (OR: 4.67; P = .014). Smoking and lower body mass index were identified as independent risk factors for hematoma development. CLINICAL IMPLICATIONS:Routine placement of a 24-h closed-suction drain does not appear to be associated with a reduction in postoperative complications after PPI. Preventive strategies should focus on meticulous intraoperative hemostasis and optimization of modifiable patient-related risk factors such as smoking. STRENGTHS AND LIMITATIONS:The study includes a relatively large cohort and standardized ultrasonographic assessment. However, its retrospective design, exclusion of complex cases, and lack of standardized hematoma grading limit generalizability and causal inference. CONCLUSIONS:Routine use of a 24-h closed-suction drain in primary three-piece PPI surgery is not associated with a reduction in hematoma, infection, or mechanical complications. Hematoma formation remains a key determinant of adverse outcomes, emphasizing the importance of careful surgical technique and patient optimization rather than routine drainage.

Abstract Introduction Closed suction drain systems are frequently used in penile prosthesis implantation surgery to prevent postoperative hematoma and fluid accumulation; however, concerns exist regarding a potential increase in infection risk. Objective This study aimed to evaluate the effect of drain usage on outcomes in patients undergoing primary three-piece inflatable penile prosthesis surgery. Methods This study, initially planned prospectively but analyzed retrospectively, included patients who underwent primary three-piece inflatable penile prosthesis surgery at our center between September 2020-August 2024. Patients who had additional surgical interventions such as grafting for Peyronie’s disease or simultaneous Wilson maneuver, or those with severe fibrosis due to priapism, were excluded. Patients were divided into two groups: those who had a closed suction drain placed and removed at 24 hours postoperatively, and those without drain placement. A third group consisted of patients whose drains were retained for more than 24 hours due to daily output exceeding 50 ml. Demographic characteristics, comorbidities (diabetes mellitus, vascular disease, Peyronie’s disease, history of radical prostatectomy), surgical features (operative time, Wilson maneuver, prosthesis type), and postoperative complications (hematoma on postoperative days 3 and 10, infection, mechanical problems) were compared. All patients with a history of anticoagulant use were bridged to low molecular weight heparin five days before the procedure. Prostheses were implanted via either penoscrotal or infrapubic approaches. Statistical analysis used the Mann–Whitney U test, Pearson’s chi-square, and Fisher’s exact test as appropriate. Results A total of 431 patients were analyzed: 149 with drains removed at 24 hours, 21 with prolonged drainage, and 261 without drains. Median age was 60(54–66) years. Comparison between the 24-hour drain group and the no-drain group showed no significant differences in age, operative time, comorbidities, or prior surgical history. However, BMI was significantly higher in the drain group (p=0.035). Although smoking rates were higher in the drain group, the difference was not statistically significant(p=0.062). Rates of hematoma, infection, and mechanical complications on postoperative days 3 and 10 were similar between groups (p>0.05). At 12 months, prosthesis malfunction occurred in 15 patients(3.7%). Early postoperative hematoma on day 3 was identified as a significant risk factor for malfunction (OR:4.67,p=0.014), while the presence of vascular disease was associated with a lower malfunction rate (OR:0.14,p=0.025). Infection developed in 2.0% of patients within the first 3 months, with the strongest predictors being hematoma on day 3 (OR: 29.0, p<0.001) and day 10 (OR: 10.6, p=0.002). Factors influencing hematoma development on day 3 included smoking, which increased hematoma risk by 2.3-fold (p=0.021), and lower BMI, which was also significantly associated (p=0.033). Smoking was the most significant risk factor for hematoma on day 10 (OR:2.11, p=0.017). Among the 21 patients followed with drains retained for more than 24 hours, only 2 developed infections within the first 3 months. Conclusions The use of drains in primary three-piece inflatable penile prosthesis surgery did not increase the rates of postoperative hematoma, infection, or mechanical complications, showing no significant differences between groups. These findings suggest that drain placement neither raises the risk of complications nor provides a clear beneficial effect on postoperative outcomes. Disclosure No

INTRODUCTION:Surgical video-based learning has rapidly shifted to unregulated open-access platforms. This study evaluates the consumption habits, clinical impact, and content selection criteria of urologists across different career stages to understand the risks of this transition. MATERIAL AND METHODS:A cross-sectional survey was conducted among 133 urologists stratified as residents, specialists, and academic urologists. Platform preferences, practice modifications, and selection criteria were assessed using Likert scales. Differences between groups were analyzed using chi-square and Kruskal-Wallis tests with post hoc pairwise comparisons. RESULTS:Open-access platforms (YouTube) were the primary source for 84.0% of the cohort, with no significant difference between groups (p: 0.351). A total of 37.4% reported modifying their surgical technique based on online videos. This rate did not differ significantly between residents (34.9%), specialists (48.0%), and academic urologists (35.0%) (p: 0.477). In adjusted analysis, career stage was not independently associated with technique modification, whereas higher weekly operative workload was associated with a greater likelihood of reporting modification. However, a significant divergence emerged in selection criteria: residents prioritized "surgeon's reputation" significantly less than specialists (p: 0.012) and academic urologists (p: 0.007). Additionally, the clarity of patient consent in online videos was rated universally low. CONCLUSION:The "YouTube era" appears to have a tangible influence on clinical practice across different seniority levels. However, potential differences in credibility assessment may exist as residents may rely more heavily on unregulated content without systematically evaluating author expertise. These findings highlight the potential value of incorporating digital literacy and source evaluation skills into residency curricula to support more informed engagement with online surgical content.

Urethral stricture is a fibrotic narrowing of the urethra with limited long-term success using minimally invasive treatments. Mesenchymal stem cells (MSCs) possess antifibrotic and regenerative properties that may offer a novel therapeutic approach. This first-in-human pilot study evaluated the safety and preliminary efficacy of Wharton’s jelly-derived MSC injections for recurrent bulbar urethral stricture. Eleven men with recurrent bulbar urethral strictures ≤ 2 cm underwent urethral dilatation followed 3–5 days later by intralesional injection of 4 × 10^6 MSCs. MSCs were cryopreserved under ultra-low temperatures, transported at 2–8 °C on the day of injection, and viability (> 70

OBJECTIVES:To clarify the impact of anogenital distance (AGD) on duloxetine success in the management of women with stress urinary incontinence (SUI). MATERIAL AND METHODS:Patients who have been diagnosed with SUI, were evaluated for inclusion in the study. Distance between anus and clitoris (AGDAC), distance between anus and fourchette (AGDAF), and length of genital hiatus (GH) were measured. All patients started duloxetine 20 mg twice daily for 2 weeks, and then patients received 40 mg duloxetine twice daily. Patients were categorized into two groups (patients who benefited from duloxetine and patients who did not benefit from duloxetine). Patient characteristics and AGD parameters were compared between these two groups. RESULTS:In total, 178 women were included in study and mean duration of SUI was 2.9 years. The mean body mass index (BMI) was significantly higher in patients with unsuccessful therapy (p = 0.001). In contrast, nulliparous rate was significantly higher in patients who benefited from duloxetine (p = 0.043). The distance of AGDAC (71.4 mm vs 77.9 mm, p = 0.001) and distance of GH were significantly shorter (21.7 mm and 26.7 mm, p = 0.001) in patients who were successfully treated with duloxetine. Multivariate regression analysis found that BMI < 30 kg/m², shorter AGDAC, and GH lengths were significantly related with duloxetine success (p = 0.037, p = 0.036, and p = 0.039, respectively). CONCLUSIONS:This study showed that duloxetine improved SUI in more than half of women and obesity was a predictive factor for duloxetine failure. In addition, shorter AGDAC length and shorter GH distance were significantly associated with duloxetine success in the management of SIU.

BACKGROUND:In recent years, artificial intelligence (AI) applications have been increasingly used as sources of medical information, alongside their applications in many other fields. This study is the first to evaluate ChatGPT's performance in addressing urological emergencies (UE). METHODS:The study included frequently asked questions (FAQs) by the public regarding UE, as well as UE-related questions formulated based on the European Association of Urology (EAU) guidelines. The FAQs were selected from questions posed by patients to doctors and hospital accounts on social media platforms (Facebook, Instagram, and X) and on websites. All questions were presented to ChatGPT 4 (premium version) in English, and the responses were recorded. Two urologists assessed the quality of the responses using a Global Quality Score (GQS) on a scale of 1 to 5. RESULTS:Of the 73 total FAQs, 53 (72.6%) received a GQS score of 5, while only two (2.7%) received a GQS score of 1. The questions with a GQS score of 1 pertained to priapism and urosepsis. The topic with the highest proportion of responses receiving a GQS score of 5 was urosepsis (82.3%), whereas the lowest scores were observed in questions related to renal trauma (66.7%) and postrenal acute kidney injury (66.7%). A total of 42 questions were formulated based on the EAU guidelines, of which 23 (54.8%) received a GQS score of 5 from the physicians. The mean GQS score for FAQs was 4.38+-1.14, which was significantly higher (p=0.009) than the mean GQS score for EAU guideline-based questions (3.88+-1.47). CONCLUSION:This study demonstrated for the first time that nearly three out of four FAQs were answered accurately and satisfactorily by ChatGPT. However, the accuracy and proficiency of ChatGPT's responses significantly decreased when addressing guideline-based questions on UE.

Reconstructive surgical options have become an alternative for female urethral stricture. Dorsal and ventral methods using oral mucosa grafts have been described, but their superiority over each other has not been evaluated. In this meta-analysis, the outcomes of dorsal and ventral techniques with oral mucosa graft in female urethroplasty have been compared. A systematic search of Pubmed, Scopus and Web of Science databases was performed according to the Preferred Reporting Items For Systematic Review And Meta-Analysis statement. Manuscripts published until February 2025 that reported the use of dorsal or ventral surgical approaches with oral mucosa grafts in female urethroplasty included. Success, determined based on the recurrence rate, was analyzed and compared between both groups. Complications were presented in both groups to evaluate the safety of the surgical technique. A total of 320 studies were identified, with 25 meeting the inclusion criteria. The meta-analysis, including four comparative cohort studies, showed no significant difference in surgical success between the dorsal (62/69 patients) and ventral (93/103 patients) techniques (OR = 0.84, 95

Aim Operative dictation (OD) is a critical component of surgical documentation, yet its formal teaching is often overlooked in residency training. This study aimed to evaluate the inclusion of OD training in urology residency programs and assess awareness and practices among urology residents (URs) and staff urologists (SUs). Materials and methods A structured questionnaire was developed to explore OD practices, awareness, and training methods. The questionnaire consisted of four sections: demographic characteristics, OD practices, awareness of OD as a skill, and formal OD training. It was distributed via e-mail to URs and SUs whose contact information was obtained from the Turkish Urological Association’s Central Anatolia Branch. Descriptive statistics were used to analyze the data. Results The survey was sent to 252 participants and achieved a response rate of 86.9% ( n = 219). Among the respondents, 61 were URs (27.8%) and 158 were SUs (72.1%). Most participants (96.7% of URs and 98.2% of SUs) reported no formal OD training during residency, informal methods, such as reviewing old ODs and guidance from senior residents, were commonly cited as learning approaches. Despite recognizing the importance of structured OD templates, participants highlighted the absence of standardized training curricula. Similar responses from experienced and novice surgeons suggest that this gap has persisted for decades. Conclusion This study highlights the lack of formal OD training in urology residency programs and the reliance on informal methods. Integrating standardized OD training modules into residency curricula is essential to improve documentation quality and medico-legal reliability. Future research should explore the effectiveness of educational interventions and develop universal guidelines for OD practices. Clinical trial number Not applicable.

BACKGROUND:Injection therapy has emerged as a possible treatment for the acute phase of Peyronie's disease (PD). AIM:To systematically review the current evidence on the efficacy and safety of injection therapy for patients in the acute phase of PD. METHODS:A comprehensive bibliographic search on the MEDLINE, Scopus, and Web of Science Core Collection databases was conducted in June 2024. Articles were selected if they included patients with PD in acute phase (P) undergoing injection therapy (I) with or without comparison with other treatments (C), evaluating its efficacy or safety (O). Prospective and retrospective original studies were included (S). Articles were assessed for risk of bias using Cochrane risk-of-bias tool for randomized trials version 2, risk of bias in non-randomized studies-of interventions, and Joanna Briggs Institute critical appraisal tool. Data were synthesized narratively. OUTCOMES:Primary outcomes were penile curvature, penile pain, and adverse events. RESULTS:A total of 20 studies (1291 patients) were included, with 4 (20%) being randomized controlled trials. The mean/median duration of PD symptoms ranged from 2.0 to 18.6 months across the papers. The injectable agents tested included calcium channel blockers, hyaluronic acid, Collagenase Clostridium histolyticum, interferon, and corticosteroids. In most studies, improvements in penile curvature and pain were observed, with variable magnitude and in a varying percentage of patients. Adverse events were mostly mild and localized, including bruising, swelling, and ecchymosis. No severe complications were reported in any of the studies. CLINICAL IMPLICATIONS:Limited evidence support the feasibility of injection therapy for the acute phase of PD. STRENGTHS AND LIMITATIONS:The first systematic review on injection therapy for acute PD. Low-to-intermediate quality and heterogeneous methodology of primary studies, impossibility of reliable quantitative data synthesis. CONCLUSION:Injection therapy for the acute phase of PD demonstrates variable efficacy depending on the agent used and a relatively favorable safety profile; however, the overall quality of evidence remains low and is characterized by significant methodological limitations.

To systematically evaluate the efficacy and safety of minimally invasive surgical treatments (MISTs)—including Aquablation, Rezum, transperineal laser prostate ablation (TPLA), prostatic artery embolization (PAE), UroLift®, and the temporary implantable nitinol device (iTIND)—in patients aged 75 years and older with BPH. A systematic review was conducted in accordance with PRISMA 2020 guidelines and EAU standards. Literature searches were performed across PubMed, Scopus, and Web of Science up to July 15, 2025. Studies were included if they reported outcomes for male patients ≥ 75 years undergoing one of the specified MISTs, with a minimum of 50 patients per treatment group. Data extraction and risk of bias assessments were performed independently by two reviewers. Out of 830 initial records, 9 studies involving a total of 1099 patients met inclusion criteria. These included three PAE studies, four on Rezum, and two on UroLift. No eligible studies were found for Aquablation, iTIND, or TPLA. The mean patient age was 79.8 years, with baseline IPSS ranging from 15 to 27. MISTs were associated with significant symptom improvement and acceptable safety profiles. Adverse events were predominantly mild (Grade 1–2), with rates ranging from 10.0 to 39.2

To evaluate the impact of three different AEEP techniques on the training performance of novices using a realistic hydrogel prostate phantom model. The experimental setup utilized realistic prostate phantom model provided by the Max Planck Institute for Intelligent Systems, Germany. For the enucleation, we utilized a new solid-state pulsed thulium laser (Thulio®, Dornier MedTech, Weßling, Germany). We explored three different AEEP techniques–bilobar, trilobar, and en-bloc–repeated ten times each, totaling 30 procedures. Median enucleation time was 9.5 min (range: 6–16), median laser time was 4.29 min (3.21–6.34), median total energy used was 25.8 kJ (19.4–38.1), and median number of laser pulses was 12.8 thousand (9.7–17). There were no significant differences in operation time, laser time, pulses, or joules among the en-bloc, two-lobe, and three-lobe techniques (p = 0.113, 0.143, 0.148, 0.141 respectively). Ultrasound evaluations showed the one-lobe technique to be superior in accuracy, smoothness, and circularity (p = 0.0002, 0.012, 0.00005 respectively) (Figs. 9, 10, 11), despite having the highest perforation rate, which was not statistically significant compared to other techniques (p = 1.4). The one-lobe technique’s higher accuracy may increase the risk of perforation. In contrast, the three-lobe technique had the lowest perforation rate and removal efficiency due to its lower accuracy. The en-bloc, bilobar, and trilobar enucleation techniques exhibited comparable operation times. The one-lobe method emerged as superior in terms of accuracy, smoothness, and circularity. However, it also presented the highest rate of perforation.

Purpose We aimed to review the literature regarding the effects of trans obturator tape surgery (TOT) on sexual functions in women with stress urinary incontinence (SUI) to reveal compact data and to reach more consistent and reliable results. Methods PRISMA statement was used in the current review. The databases of PubMed (Medline), Science Direct, and Cochrane Central Register of Controlled Trials were detected independently. We evaluated the studies comparing the preoperative and postoperative sexuality parameters related to the TOT procedure in females. Studies presenting the mean and standard deviation(SD) of global and sub-item Female Sexual Function Index(FSFI) were included in the current study. Results We identified 783 studies in full publications or abstract forms using the methodology above and the search terms. Finally, eight studies were included in the meta-analysis. The pooled analysis of the mean difference demonstrated that the total sexual function scores of the patients improved after TOT surgery. Conclusion The data collected from the current meta-analysis suggest that TOT surgery improves female sexual function.

OBJECTIVE:The internet and social media have become primary sources of health information, with men frequently turning to these platforms before seeking professional help. Chat generative pretrained transformer (ChatGPT), an artificial intelligence model developed by OpenAI, has gained popularity as a natural language processing program. The present study evaluated the accuracy and reproducibility of ChatGPT's responses to andrology-related questions. METHODS:The study analyzed frequently asked andrology questions from health forums, hospital websites, and social media platforms like YouTube and Instagram. Questions were categorized into topics like male hypogonadism, erectile dysfunction, etc. The European Association of Urology (EAU) guideline recommendations were also included. These questions were input into ChatGPT, and responses were evaluated by 3 experienced urologists who scored them on a scale of 1 to 4. RESULTS:Out of 136 evaluated questions, 108 met the criteria. Of these, 87.9% received correct and adequate answers, 9.3% were correct but insufficient, and 3 responses contained both correct and incorrect information. No question was answered completely wrong. The highest correct answer rates were for disorders of ejaculation, penile curvature, and male hypogonadism. The EAU guideline-based questions achieved a correctness rate of 86.3%. The reproducibility of the answers was over 90%. CONCLUSION:The study found that ChatGPT provided accurate and reliable answers to over 80% of andrology-related questions. While limitations exist, such as potential outdated data and inability to understand emotional aspects, ChatGPT's potential in the health-care sector is promising. Collaborating with health-care professionals during artificial intelligence model development could enhance its reliability.

Determinar la relación entre la impactación de los cálculos ureterales y la formación de estenosis ureterales y los factores asociados. Se analizaron retrospectivamente los registros médicos de todos los pacientes sometidos a cirugía endoscópica por cálculos ureterales impactados en 3 hospitales universitarios de Turquía, Reino Unido y España entre junio de 2019 y enero de 2022. Los parámetros examinados incluyeron los datos demográficos del paciente, lateralidad, tamaño y localización del cálculo, tiempo entre el inicio de los síntomas y la cirugía, tipo de ureteroscopia (rígida/flexible), presencia de nefrostomía o catéter doble J antes de la ureteroscopia, complicaciones intraoperatorias (avulsión/perforación), estado libre de cálculos, número de procedimientos necesarios para obtener un estado libre de cálculos y los resultados de las pruebas de imagen postoperatorias. Un total de 41 pacientes, 25 varones y 16 mujeres, de 3 instituciones fueron incluidos en el estudio. La edad media de los pacientes era de 48,2 ± 13,5 años. La mediana del diámetro mayor de los cálculos fue de 9 mm (RIC: 8 mm). Catorce (34,1%) pacientes desarrollaron estenosis ureteral después de la ureteroscopia. No hubo diferencias entre los pacientes que desarrollaron estenosis ureteral y los que no la desarrollaron en cuanto a la lateralidad, la localización, la hidronefrosis y la multiplicidad de los cálculos (p = 0,58, p = 0,14, p = 0,79 y p = 0,31, respectivamente). Los pacientes que desarrollaron estenosis ureteral presentaron una tasa más elevada de derivación urinaria preoperatoria, como nefrostomía o catéter doble J (p = 0,000). La interrupción del paso de la orina por el uréter mediante derivación urinaria con nefrostomía o catéter doble J antes de la cirugía de cálculos ureterales podría favorecer la formación de estenosis ureteral en el postoperatorio. To determine the relation between ureteral stone impaction and ureteral stricture formation and associated factors. We retrospectively analyzed the medical records of all patients who underwent endoscopic ureteral stone surgery for impacted ureteral stone at 3 academic institutions in Turkey, United Kingdom and Spain between June 2019 and January 2022. Examined parameters included patient demographics, stone side, size and localization, time between initiation of symptoms and surgery, type of ureteroscopy (rigid/flexible), presence of nephrostomy or double-J stent prior to ureteroscopy, intraoperative complications (avulsion/perforation), stone-free status, number of procedures required for stone-free status, postoperative imaging results. A total of 41 patients whom 25 were male and 16 were female, from 3 institutions were included the study. The mean age of the patients was 48.2 ± 13.5 years. The median largest diameter of the stones was 9 mm (IQR: 8 mm). Fourteen (34.1%) patients developed ureteral strictures following ureteroscopy. There was no difference between patients who developed ureteral strictures and patients who did not developed strictures in terms of stone laterality, stone location, hydronephrosis and multiplicity (p = 0.58, p = 0.14, p = 0.79 and p = 0.31, respectively). Patients who developed ureteral strictures had a higher rate of preoperative urinary diversion such as nephrostomy or double-J stent (p = 0.000). Interruption of urine passage through ureter via urinary diversion such as nephrostomy or double-J stent prior to ureteral stone surgery might lead ureteral stricture formation in the postoperative period.

Kaposi's sarcoma should be considered in the differential diagnosis in young patients with penile lesions and no risk factors. A 37-year-old heterosexual man with no other medical history applied presented with a non-itchy and painless penile lesion, for three months. The HIV 1-2 serology was negative via ELISA test. Histopathological analysis of the lesion revealed a tumor composed of atypical spindle cells, below a partially ulcerated surface. There was also an abundance of plasma cells admixed within the neoplastic cells. The patient was diagnosed as HIV-negative, HHV-8 positive Kaposi sarcoma. Although penile Kaposi sarcoma is extremely rare, classical Kaposi sarcoma should be considered in the differential diagnosis of penile lesions.

OBJECTIVE:To determine the relation between ureteral stone impaction and ureteral stricture formation and associated factors. MATERIAL AND METHODS:We retrospectively analyzed the medical records of all patients who underwent endoscopic ureteral stone surgery for impacted ureteral stone at three academic institutions in Turkey, United Kingdom and Spain between June 2019 and January 2022. Examined parameters included patient demographics, stone side, size and localization, time between initiation of symptoms and surgery, type of ureteroscopy (rigid/flexible), presence of nephrostomy or double-J stent prior to URS, intraoperative complications (avulsion/perforation, stone-free status, number of procedures required for stone-free status, postoperative imaging results. RESULTS:A total of 41 patients whom 25 were male and 16 were female, from 3 institutions were included the study. The mean age of the patients was 48.2 ± 13.5 years. The median largest diameter of the stones was 9 mm (IQR: 8 mm). Total 14 (34.1%) patients developed ureteral strictures following ureteroscopy. There was no difference between patients who developed ureteral strictures and patients who did not developed strictures in terms of stone laterality, stone location, hydronephrosis and multiplicity, p = 0.58, p = 0.14, p = 0.79 and p = 0.31. Patients who developed ureteral strictures had a higher rate of preoperative urinary diversion such as nephrostomy or DJS, p = 0.000. CONCLUSION:Interruption of urine passage through ureter via urinary diversion such as nephrostomy or DJS stent prior to ureteral stone surgery might lead ureteral stricture formation in the postoperative period.

Despite developing surgical techniques in urethral surgery, the outcome and complications are still unsatisfactory. Alternative treatment modality has been coming up, particularly in patients with longer stricture, under revision surgery, and penile stricture. Tissue engineering grafts are a promising approach for substituting urethral reconstruction. Over the decades, numerous preclinical studies have been published to show the efficacy and safety of different origins of materials, the presence of autologous cells (acellular matrices or autologous cell-seeded matrices), and the construction of engineered tissue (patch or tubularized constructs) on animal models. However, the results of these studies have not yet reached the intended level for daily clinical practice. A PubMed database search was performed for articles, using specific keywords, published between 1998 and 2022, with a selection on using tissue-engineered grafts for urethroplasty. Many materials have been used as a graft, such as acellular bladder matrix, small intestinal submucosa, acellular dermal matrix, and polyglycolic acid with or without cells, and were evaluated according to the functional and anatomical outcomes comprising complications. According to current literature, tubularized scaffolds constructed from co-cultured cells have promising results for the future. However, high-quality evidence through randomized controlled studies with larger sample sizes, with a long-term follow-up is required to determine accurate outcomes.

Introduction The aim of this study was to evaluate patient and partner satisfaction, device reliability, and complications in patients who underwent two-piece inflatable penile prosthesis (IPP) implantation. Patients and methods The data of 22 patients who underwent two-piece inflatable penile prosthesis implantation in our department between 2015 and 2018 were retrospectively analyzed, and a detailed review of all clinical reports was performed. Phone or face-to-face interviews were undertaken to assess the satisfaction rates of the patients and their partners using the modified Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire. Results The mean patient age and partner age were 57.95 ± 6.16 and 58.12 ± 6.66 years, respectively. The mean erectile dysfunction (ED) period was 5.33 ± 2.16 years, and the etiologies of erectile dysfunction were radical pelvic surgery (41%), diabetes mellitus (37%), and vascular disorders (22%). The mean operative time and postoperative hospital stay were 102 ± 29 minutes and 1.8 ± 0.66 days, respectively. Over a mean follow-up period of 29.04 ± 14.48 months, two (9%) cases underwent revision surgery due to mechanical device failure in one and infection in the other. The overall patient and partner satisfaction rates were 73% and 59%, respectively. Conclusions The two-piece inflatable penile prosthesis is an effective, reliable, and user-friendly prosthesis with acceptable complication and revision rates and provides a high level of patient and partner satisfaction in selected and fully informed patients.

Objective: In this case report, we aimed to present our clinical experience in a patient with hydronephrotic and atrophic kidney due to impacted lower ureteral stone. Case description: A 56-year-old male was admitted to our emergency department with flank pain and nausea. A computed tomography scan revealed a 3 cm stone at the distal ureter, causing severe hydroureteronephrosis. Right kidney parenchyma was extremely thin at the medial zone, and some parenchyma was apparent at the upper and lower poles. We planned renal scintigraphy, but it was impossible to perform quickly due to the active appointment list. The patient’s kidney was assumed to be atrophic/non-functioning; however, given the long waiting list for renal scintigraphy and the patient’s intractable pain, we decided to relieve the patient’s pain with urinary drainage. Nephrostomy insertion was denied because of the extra thin parenchyma. About 40 days later, the patient underwent semi-rigid ureterorenoscopy under spinal anesthesia. It was impossible to place a double J stent to the ureter because of the kinked and extremely dilated ureter. So, we decided to place an open-end 6Fr ureter catheter. DMSA renal scintigraphy showed 33% right kidney and 67% left kidney function. Conclusion: Intractable flank pain might be a predictor of functioning renal parenchyma in hydronephrotic/atrophic kidneys. Renal split function lower than 10% on DMSA scintigraphy might not be an absolute indication of nephrectomy, especially in the obstructed renal unit. Evaluation of renal function after eliminating obstruction might be more reliable.