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

Aim: In this study, we aimed to compare patients with acquired symptomatic bladder diverticula who underwent open diverticulectomy or endoscopic diverticulum fulguration. Material and Methods: The data of patients between January 2018 and January 2023 were retrospectively reviewed. Demographic data, laboratory parameters, and perioperative and postoperative data were noted. International Prostate Symptom Score (IPSS) and Quality of Life (QOL) scores were analyzed. Patients who underwent open diverticulectomy were classified as Group 1 and patients who underwent endoscopic diverticulectomy were classified as Group 2. Results: A total of 15 patients were included in the study. The operation time was 67 +/- 21.2 minutes in Group 1 and 22.3 +/- 10.1 minutes in Group 2, a significantly shorter operation time in Group 2. (p= 0.001) The mean hospital stay was 3.1 +/- 1.2 days in Group 1 and 1.1 +/- 0.3 days in Group 2, significantly shorter hospital stay in Group 2. (p=0.01) The rate of symptom improvement was similar. There was a significant decrease in PMR measurements in both groups in the postoperative period. QoL evaluation showed a significant increase in both groups. The complication rates were similar. Discussion: In patients with symptomatic bladder diverticula, endoscopic fulguration provides similar efficacy and safety to open surgery. It can be preferred comorbid patients with high anesthesia risk due to shorter operations and hospital stays.

Radical prostatectomy (RP) alone has traditionally been considered insufficient for patients with high-risk localized prostate cancer (HRPC) owing to the frequent need for adjuvant salvage radiotherapy or androgen deprivation therapy (ADT) following surgery. Previously, systemic therapy, such as ADT, was the standard treatment for metastatic prostate cancer (PC) patients; RP was not considered viable for these patients. However, since 2015, there has been a recognition that metastatic PC patients can be categorized based on the extent of their metastases, leading to the consideration of RP for some metastatic cases. In recent years, the concept of cytoreductive RP has gained traction; studies suggest that it may improve survival rates in metastatic PC patients through mechanisms, such as tumor debulking and enhancement of the immune response. A meta-analysis of retrospective studies has shown that cytoreductive RP is associated with higher cancer-specific survival rates at 1-year, 3-year, and 5-year intervals compared with systemic therapy alone. In our study, which followed HRPC and oligometastatic PC patients for an average of 46 months, we observed biochemical recurrence in 17.8% of HRPC and 13% of oligometastatic patients, with overall survival rates of 96.4% and 87%, respectively. Although prospective or randomized studies are still lacking, current retrospective studies, including our own, suggest promising outcomes for RP in HRPC and oligometastatic patients. With the increasing prevalence of robotic surgery, improved pelvic anatomy observation, and growing surgical confidence, the realization of prospective randomized study results may not be far off.

Although renal angiomyolipomas (AMLs) are benign lesions, they can grow and cause serious complications. In this study, we aimed to determine the factors affecting the growth of renal AMLs. Patients followed up for AMLs between January 2014 and January 2024 were screened. By accepting 2.5 mm/year as the limit for a significant growth rate, the patients were divided into two groups: those with and without significant growth. Demographic characteristics, tumor characteristics, and laboratory parameters, platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and aspartate aminotransferase-to-alanine aminotransferase (De Ritis) ratio, were compared between the groups. The study included a total of 98 patients. Of the entire cohort, 78.6

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.

Aim: To compare the results of retrograde ureteral stent (RUS) and percutaneous nephrostomy (PCN) procedures for decompression in patients with acute obstructive pyelonephritis. Patients and Methods: Medical records of patients undergoing PCN or RUS for emergency urinary diversion because of obstructive pyelonephritis were evaluated retrospectively. Patients with urinary tract obstruction and concurrent fever (≥38°C), pyuria, and costovertebral angle tenderness were included and divided into two groups based on the type of emergency urinary drainage applied (PCN in Group 1) and (RUS in Group 2). Apart from the demographic data and Charlson Comorbidity Index, laboratory and radiologic examination outcomes were well evaluated. Results: A total of 155 patients including 73 patients (47.1%) undergoing PCN (Group 1) and 82 patients (52.9%) undergoing RUS (Group 2). Although no significant difference was found regarding the demographic characteristics, the operation time, as well as fluoroscopy time, was significantly shorter in Group 1 cases when compared with those in Group 2 (p < 0.0001). The success rate was similar between the two groups, and there was also a significant difference regarding the complication rates in both groups of cases (5.5% vs 7.3%). Conclusions: Our findings showed that despite similar efficacy and success rates noted between PCN and RUS applications in the emergency drainage of cases presenting with obstructive pyelonephritis, PCN application was found to be advantageous because of shorter operation and fluoroscopy durations. More importantly, this approach was associated with a significantly less need for intensive care during the postoperative period.

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

Objective: In this study, we aimed to investigate whether there is a difference in the reliability and efficacy of the method according to age in patients divided into 3 different age groups who underwent RIRS due to kidney stones. Materials and Methods: Patients who underwent Retrograde Intra Renal Surgery (RIRS) for kidney or ureteral stone disease at the Urology Clinic of Health Sciences University Umraniye Health Application and Research Hospital between May 2017 and January 2021 were retrospectively screened, and those aged 20-80 years were included in the study. The demographic and clinical data of the patients and stone-related data were recorded. Patients aged 20-40 years were classified as Group 1, those aged 41- 60 years as Group 2, and those aged 61-80 years as Group 3. Results: After the inclusion and exclusion criteria were applied, the sample consisted of a total of 320 patients, of whom 121 (37.8%) were in Group 1, 133 (41.5%) were in Group 2, and 66 (20.6%) were in Group 3. The mean operative times and stone-free rates were similar between the groups. However, the mean hospital stay was significantly longer in Groups 3 compared to Groups 1 and 2. The minor complication rates were 2.4% in Group 1, 3% in Group 2, and 13.6% in Group 3, indicating a statistically significantly higher value in Group 3 compared to the remaining two groups (p=0.03). The major complication rates of Groups 1, 2, and 3 were 0.8%, 0.7%, and 7.5%, respectively. Accordingly, Group 3 had a significantly higher rate than Groups 1 and 2 (p=0.04). Conclusion: RIRS can be performed on the elderly with success rates comparable to other age groups. However, the elderly, who represent a higher-risk patient population with more comorbidities, have increased rates of minor and major complications both in the perioperative and postoperative periods.

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.

ÖZETSpermatoseller genellikle asemptomatiktir ve sıklıkla fizik muayene sırasında insidental olarak saptanırlar.Burada hidroseli taklit eden dev multiloküler spermatosel olgusunu sunmayı amaçladık.79 yaşında erkek hasta birkaç yıldır var olan sol skrotal şişlik, ara ara olan skrotal ağrı şikayetleriyle kliniğimize başvurdu.Palpasyonda sağ skrotumda yaklaşık 10-15 cm boyutlarında sert kitle tespit edildi.Yapılan skrotal renkli Doppler ultrasonografide sağ skrotumda içi sıvı dolu yaklaşık