Purpose: We aimed to assess the perioperative, oncological, and functional outcomes of patients aged 70 years or older following retroperitoneal laparoscopic partial nephrectomy (LPN) and compare their results with younger patients. Materials and Methods: A retrospective review of our prospectively maintained database identified 329 patients who underwent retroperitoneal LPN from January 2013 to October 2022. The patients divided into 2 groups defined by age >= 70 or <70 years at the time of surgery. A propensity score matching analysis was conducted to obtain two balanced groups. The groups were compared for safety (perioperative outcomes) and efficacy (oncological and functional outcomes). Results: After matching, all variables were well balanced with no differences between the two cohorts. No significant differences were found in perioperative outcomes, including operative time, warm ischemia time, blood loss, hospital stay, and complications (P values >.05). Concerning functional outcomes, postoperative glomerular filtration rate and decrease in glomerular filtration rate were significantly better in the younger group compared with the elderly groups (P = .003 and P = .001, respectively). Although margin, ischemia, complications rates were similar between the cohorts (P = .068), Pentafecta rates were lower in the elderly patients (P = .029). In terms of oncological outcomes, recurrence-free survival and cancer-specific survival were comparable between the groups. Conclusion: Retroperitoneal LPN can be performed safely and with adequate oncological efficacy in elderly patients.

Pathological upgrading poses a significant challenge in treatment decision-making, particularly for patients considered for active surveillance (AS). This study aimed to devise a novel scoring system to predict the risk of upgrading in patients with biopsy Gleason grade group 1 prostate cancer. We conducted a retrospective review of 235 patients who underwent radical prostatectomy between February 2014 and June 2022. Data on patient age, prostate-specific antigen (PSA) level, body mass index, clinical T-stage, prior biopsy history, Prostate Imaging-Reporting and Data System (PIRADS) score, time interval from biopsy to surgery, and pathological outcomes were collected. After a comprehensive review of the literature, multivariate analyses identified seven factors associated with upgrading in prostate cancer patients after radical prostatectomy: uninformative prior biopsy sample, PSA level, greatest percentage of tumor involvement, radiological PIRADS score, age, delay from biopsy to surgery and extension of positive cores. These factors were integrated into our devised U.P.G.R.A.D.E. model to form a scoring system. The U.P.G.R.A.D.E. score was calculated based on the cumulative score of these variables. The predictive performance of the U.P.G.R.A.D.E. scoring system was assessed, revealing a cohort with a mean age of 64.22 +/- 5.88 years and a mean PSA value of 8.92 +/- 5.05 ng/mL. The pathological samples of 95 patients (40.6%) were upgraded, and the upgraded patients exhibited significantly higher U.P.G.R.A.D.E. scores (p <0.001). The area under the receiver operating characteristic (AUROC) curve for the U.P.G.R.A.D.E. scoring system demonstrated robust predictive ability for upgrading (AUROC = 0.952; 95% Confidence interval (CI): 0.926-0.978; p < 0.001). In addition, a higher U.P.G.R.A.D.E. score was strongly associated with an increased risk of upgrading in biopsy Gleason grade group 1 patients, suggesting potential limitations for active surveillance eligibility in these individuals. Further validation studies are warranted to confirm these initial findings.

INTRODUCTION:The aim of the study was to investigate the effect of the diameter of the ureteral access sheath (UAS) used during RIRS on kidney injury based on acute kidney injury (AKI) biomarkers.METHODS:This prospectively randomized controlled study included a total of 125 patients divided into three groups: group 1 (n = 52) in which a 12/14 Fr UAS was used, group 2 (n = 52) in which a 9.5/11.5 Fr UAS was used, and group 3 (n = 21) that was designed as the control group with no urogenital disease history. Urine samples were collected preoperatively and at the postoperative second and 24th hours after surgery and analyzed for AKI using the urinary kidney injury molecule-1 (uKIM-1), N-acetyl-ß-D-glucosaminidase, and neutrophil gelatinase-associated lipocain biomarkers.RESULTS:In group 1, there was no statistical change in any of the three AKI biomarkers at the postoperative second or 24th hour compared to the preoperative period. In group 2, the values of all three AKI biomarkers were statistically significantly increased at the postoperative second and 24th hours compared to the preoperative period while no statistical difference was observed between the two postoperative evaluation times. At the postoperative second hour, the uKIM-1 value was statistically significantly higher in group 2 compared to group 1 (p = 0.043).CONCLUSIONS:The results of our study showed that AKI was not observed in RIRS performed with a 12/14 Fr UAS while the use of a 9.5/11.5 Fr UAS resulted in AKI according to the assessment of the related biomarkers.

This study aimed to compare the anterolateral and posterior localized renal masses in laparoscopic partial nephrectomy with the retroperitoneal approach in terms of operative, functional, and oncological outcomes. Patients who underwent retroperitoneal laparoscopic partial nephrectomy by a single surgeon between January 2013 and January 2021 were included in the study. A one-to-one propensity score matching (PSM) analysis was conducted to obtain two balanced groups. The patients were divided into two groups as posterior and anterolateral according to the localization of the mass. A total of 239 patients were included in the PSM analysis, with 65 patients allocated to each group. The mean operative time was 79.2 ± 11.2 min in the posterior group, while it was 90.0 ± 11.6 min in the anterolateral group (P < 0.001). Warm ischemia time was 15.9 ± 2.4 min in the posterior group and 18.6 ± 2.7 min in the anterolateral group (P < 0.001). The median decrease in eGFR at 1 year was 4.8 (IQR, 2.9–6.9) mL/min in the posterior group and 5.0 (IQR, 2.8–11) mL/min in the anterolateral group (P = 0.219). The warm ischemia time and clamping technique were found to be significant factors for predicting eGFR change after surgery (β:0.693, 95% CI: 0.39–0.99, P < 0.001; β:6.43, 95% CI: 1.1–11.7, P = 0.017, respectively). We report that retroperitoneal laparoscopic partial nephrectomy provided longer warm ischemia and operative time for anterolateral renal masses than posterior masses. However, long-term oncological and functional results were similar for both localizations.

Purpose To determine the factors affecting morcellation efficiency in holmium laser enucleation of the prostate (HoLEP) surgery. Materials and Methods Patients who underwent HoLEP surgery by a single surgeon between 2018 and 2022 were included in the study. Our primary outcome of interest in this study was morcellation efficiency. The effect of preoperative and perioperative variables on morcellation efficiency was evaluated with linear regression analysis. Results A total of 410 patients were included in the study. The mean morcellation efficiency was 6.95±1.70 g/min. Univariable and multivariable linear regression analysis was performed to identify factors affecting morcellation efficiency. Presence of the “beach ball” effect (small, round prostatic tissue fragments that are fibrotic and difficult to morcellate), the learning curve, resectoscope sheath type, prostate-specific antigen (PSA) density, morcellated tissue weight, and the presence of prostate calcification were found to be independent predictive factors (β=-1.107, 95% CI: -1.59 to -0.55, p<0.001; β=-0.514, 95% CI: -0.85 to -0.17, p=0.003; β=-0.394, 95% CI: -0.65 to -0.13, p=0.003; β=-0.302, 95% CI: -0.59 to -0.09, p=0.043; β=0.062, 95% CI: 0.05 to 0.06, p<0.001; β=-0.329, 95% CI: -0.55 to -0.10, p=0.004; respectively). Conclusions This study reports that presence of the beach ball effect, the learning curve, small resectoscope sheath, PSA density, and presence of prostate calcification negatively affect morcellation efficiency. On the contrary, morcellated tissue weight has a linear relationship with morcellation efficiency.

Amaç: Bu çalışmada obezitenin ekstraperitoneal laparoskopik radikal prostatektomi (LRP) yapılan hastalarda perioperatif ve fonksiyonel sonuçlara etkisini değerlendirmeyi amaçladık. Gereç ve yöntem: Etik kurul onayı alındıktan sonra Nisan 2014-Haziran 2018 tarihleri arasında lokalize prostat kanseri nedeniyle ekstraperitoneal LRP yapılan hastaların verileri retrospektif olarak incelendi. Takip süresi 12 aydan kısa olan, takipten çıkan, preoperatif hormonoterapi alan, pelvik cerrahi veya radyoterapi öyküsü olan ve verileri eksik olan hastalar çalışma dışı bırakıldı. Hastaların demografik dataları, perioperatif bulgular, patoloji sonuçları ve takiplerdeki onkolojik ve fonksiyonel sonuçlar kaydedildi. VKİ ≥ 30 kg/m2 olan hastalar obez gruba dahil edildi. Bulgular: Çalışmaya toplamda 160 hasta dahil edildi. Obez grubunda 64 hasta, obez olmayan grupta ise 96 hasta mevcuttu. Obez grubundaki 64 hastanın yaş ortalaması 66,06±5,6, obez olmayan gruptaki 96 hastanın yaş ortalaması ise 66,74±5,2 idi. Preoperatif IIEF skorları obez hasta grubunda anlamlı olarak daha düşüktü. Her iki grup, yaş, PSA, CCI, biyopsi GS, klinik evre, intraoperatif ve postoperatif komplikasyonlar açısından benzer özelliklere sahipti. Ayrıca iki grup, postoperatif onkolojik sonuçlar, biyokimyasal rekürrens, kontinans ve IIEF skorlarındaki düşüş açısından karşılaştırıldığında anlamlı fark gözlenmedi. Sonuç: Prostat kanserli obez hastalarda ekstraperitoneal LRP, benzer onkolojik ve fonksiyonel sonuçlarla uygulanabilen, güvenli ve etkili bir tedavi metodu olarak görünmektedir.

Amaç Üroloji kılavuzlarında 10-20 mm arası alt pol taşlarında özellikle ekstrakorporal şok dalga litotripsi (SWL)'nin başarısız olduğu veya SWL'nin uygun olmadığı durumlarda endoürolojik tedaviler olan perkütan nefrolitotomi (PCNL) ve retrograd intrarenal cerrahi (RİRC) önerilmektedir. Bu çalışmada 10-20 mm arası alt pol taşlarında RİRC ile mini perkütan nefrolitotomi (m-PCNL) uygulanan hastaların sonuçlarını karşılaştırdık. Gereç ve Yöntem 2020 ile 2022 yılları arasında 10-20 mm arası alt pol böbrek taşı nedeniyle endoürolojik tedavi (RİRC veya m-PCNL) uygulanan 116’sı RİRC, 71’i m-PCNL olan toplam 187 hastanın dosyaları retrospektif olarak incelendi. Preoperatif yanlılıkları önlemek için 1:1 oranı temel alınarak eğilim skoru eşleştirmesi (propensity score-match) uygulandı. Analiz sonucuna göre RİRC uygulanan 65 hasta ve m-PCNL uygulanan 65 hasta çalışmaya dahil edildi. İki grup arasında intraoperatif (operasyon süresi, floroskopi süresi) ve postoperatif bulgular (hastane yatış süresi, hematokrit düşüşü, taşsızlık oranları ve komplikasyonlar) karşılaştırıldı. Operasyon sonrası 4 mm veya daha büyük taş saptanması klinik anlamlı rezidü olarak tanımlandı. Komplikasyonlar Clavien skorlama sistemine göre ve intraoperatif-postoperatif olarak sınıflandırıldı. Bulgular Her iki grup, demografik özellikler (yaş, cinsiyet, vücut kitle indeksi), radyografik taş karakteristikleri (taş boyutu, taş lateralitesi, taş opasitesi, ve taş dansitesi) açısından karşılaştırıldığında istatistiksel olarak anlamlı fark gözlenmedi. Operasyon süresi, floroskopi süresi, hastane yatış süresi açısından gruplar karşı- laştırıldığında, RİRC grubunda bu süreler istatistiksel olarak anlamlı derecede daha kısaydı (p

Aim: Although the 26F resectoscope is frequently used in transurethral prostatectomy, there are some concerns with high-caliber shafts. We compared 24F and 26F resectoscope used for Holmium Laser Enucleation of the Prostate (HoLEP) in terms of effects on postoperative urethral complications and perioperative outcomes. Methods: Data from patients undergoing HoLEP from 2017 to 2021 was retrospectively analyzed. All surgeries were completed by a single surgeon. The patients were divided into one of two groups according to the resectoscope diameter (24F or 26F). All patients were followed up for urethral complications for 12 months. Perioperative outcomes and urethral complications were compared between the groups. Results: The study included 301 patients. The mean age of patients was 68.5 +/- 8.3 and 69.1 +/- 8.6 for the 26F group (n=180) and the 24F group (n=121), respectively (p=0.608). A total of seven in the 26F group (3.8%) and 3 patients in the 24F group (2.4%) had postoperative urethral stricture (US) (p=0.503). Besides, 2 patients (26F) and 1 patient (24F) had postoperative bladder neck contracture (BNC) (p=0.807). The operation efficiency was 1.25 g/min in the 26F group and 1.17 g/min in the 24F group (p=0.005). Conclusion: The use of 24F or 26F RS was not shown to cause statistically significant differences in the incidence of US and BNC during the 12-month follow-up. The use of the 24F RS significantly reduces surgical and morcellation efficiency.

Background: We aim to directly compare the feasibility and safety of extended pelvic lymph node dissection (PLND) during transperitoneal robotic-assisted radical prostatectomy (Tp-RARP) and extraperitoneal laparoscopic radical prostatectomy (Ep-LRP). Materials and Methods: We retrospectively identified the prospectively maintained database records of 162 patients diagnosed with prostate cancer (PC) who underwent Ep-LRP or Tp-RARP with extended PLND. Patients with risk of nodal metastases over 5% according to Briganti nomogram received extended PLND. All data analyzed in this study were based on the documentation in our PC database including age, body mass index, Charlson comorbidity index score, preoperative prostate-specific antigen, history of abdominal surgery, biopsy Gleason score, total operation time, postoperative pelvic drainage time, pathological results, lymph node yield (LNY), percentage lymph node involvement (%LNI), and perioperative complications. Patients were followed up for biochemical recurrence in the postoperative period. Results: Eighty-two of the 162 enrolled patients were in group 1 (Ep-LRP+PLND) and 80 were in group 2 (Tp-RARP+PLND). There were no statistically significant differences between the groups regarding preoperative demographics and clinical characteristics. The median LNY was 17 (range 8-27) and 17.5 (range 10-29) in groups 1 and 2, respectively, and no statistically significant difference was found. There was no significant difference between the groups in terms of biochemical recurrence-free survival with mean follow-up of 44.8 months after radical surgery. Conclusion: Our results support the view that extended PLND through the Ep-LRP approach is a feasible and safe procedure without compromising oncological efficacy compared with a similar template attempted during Tp-RARP. Clinical Trial Registration number is 01/21-2.

To assess the efficacy and morbidity of the holmium laser enucleation of the prostate and bipolar transurethral enucleation of the prostate in patients with benign prostatic hyperplasia. The study included 60 (55%) and 49 (45%) patients who underwent laser and bipolar enucleation of the prostate respectively. According to the perioperative data, except for length of hospital stay and enucleated prostate weight, all the remaining parameters were similar between the groups. There were significant differences between the preoperative and the postoperative third and 12th month voiding parameters in both groups. In the laser group, the maximum urine flow rate value was better than the bipolar group at the postoperative third and 12th months. However, we did not find any statistically significant difference between the groups in terms of the serum prostate-specific antigen level, International Prostate Symptom Score and postvoid residual urine volume at the postoperative third and 12th months. Our results show that both laser and bipolar techniques are effective minimally invasive surgical treatment options for men with benign prostatic hyperplasia. When compared to bipolar technique, laser technique provides shorter hospital stay, more prostatic tissue enucleation and better maximum urine flow rate values.

Purpose: We aim to document the feasibility, perioperative safety, and the 12-month efficacy of holmium laser enucleation of the prostate (HoLEP) within 1–3 weeks following transrectal ultrasound (TRUS)-guided prostate biopsy. Methods: Data of the patients who underwent HoLEP following TRUS-guided prostate biopsy between March 2017 and July 2020 were analyzed retrospectively. Patients were divided into 2 groups: group 1 had undergone HoLEP in the early period after TRUS-guided prostate biopsy, while group 2 patients were biopsy-naive (“control group”). All patients were assessed preoperatively by a physical examination with the digital rectal examination; time from biopsy to HoLEP; measurement of Qmax, postvoiding residual volume, and prostate volume by transabdominal ultrasonography; serum prostate-specific antigen level, the International Prostate Symptom Score (IPSS); the International Index of Erectile Function-5 questionnaire; and urine analysis. The patients were reevaluated at 3- and 12-month follow-up. Perioperative and postoperative complications were documented according to the modified Clavien-Dindo System. Results: Group 1 comprised 66 patients with a mean age of 67.3 ± 6.7 (range, 53–86) years, and group 2 comprised 114 patients with a mean age of 69.4 ± 9.4 (range, 36–95) years. The operation, enucleation, and morcellation efficiencies were not statistically significant between the groups. Preoperative Qmax and IPSS values were significantly improved after HoLEP surgery in the 3rd and 12th months in all patients. Our complication rates were similar in both groups. Conclusion: High-powered HoLEP using 140 W energy within 1–3 weeks following TRUS-guided prostate biopsy is a feasible procedure with high enucleation efficiency, low perioperative morbidity, and excellent functional outcomes. A recent TRUS-guided prostate biopsy is not a contraindication to HoLEP.

OBJECTIVE:This study aimed to assess the perioperative and the 12-month efficacy and safety of 140 W high-powered holmium laser for enucleation of the prostate (HP-HoLEP) for the treatment of benign prostatic obstruction.MATERIAL AND METHODS:The data of 540 patients who underwent HoLEP by a single surgeon were analyzed retrospectively. Preoperative evaluation included a physical examination with a digital rectal examination, measurement of maximum urinary flow rate (Qmax), postvoid residual volume (PVR) and prostate volume by transabdominal ultrasonography, serum prostate-specific antigen (PSA), international prostate symptom score (I-PSS) and international index of erectile function-5 (IIEF-5) questionnaires, and urine analysis. Morcellation, enucleation, and operation efficiencies were calculated with the resected weight divided by morcellation, enucleation, and operative times, respectively. The patients were reassessed at 1, 3, 6, and 12 months after surgery by I-PSS, IIEF-5, Qmax, PSA, and the occurrence of complications.RESULTS:The mean operative time was 65.2±20.9 minutes. The mean enucleation time and efficiency were 53±15.1 minutes and 1.72±0.4 g/min, respectively. The mean morcellation time and efficiency were 12.3±15.1 minutes and 7.4±3.2 g/min respectively. Clavien grade 1 complications were observed in 102 (18.9%) patients, Clavien grade 2 complications in 20 (3.7%) patients, and Clavien grade 3b complications in 23 (5.4%) patients. I-PSS, Qmax, and IIEF-5 at postoperative 1, 3, 6, and 12 months were significantly better than baseline results.CONCLUSION:Our study demonstrated that 140 W HP-HoLEP can be performed with high enucleation efficiency, low perioperative and postoperative complication rates, and excellent functional results.

Introduction: To compare the prostate removal speeds of 3 enucleation techniques and to evaluate how the operating times change depending on the prostate volume. Methods: Medical records of patients with 80-g or larger prostates who underwent holmium laser enucleation of the prostate (HoLEP), laparoscopic simple prostatectomy (LSP), or open prostatectomy (OP) due to medical treatment-resistant benign prostatic hyperplasia (BPH) were reviewed retrospectively. Patients were classified into 3 groups according to the surgical procedure. Age, BMI, prostate weights, total operation times, prostate removal speeds, hospitalization and catheterization days, complications, and improvements on functional outcomes in the 3rd month of follow-up were compared between groups. In addition, the association between prostate weight and total operation time was analyzed for each group. Results: HoLEP, LSP, and OP groups consisted of 60, 61, and 37 patients, respectively. While HoLEP was similar to OP in terms of prostate removal speed and total operation time, LSP was statistically slower and required more operation time than HoLEP and OP. There was a relationship between prostate weight and total operation time only in HoLEP. Conclusion: LSP, one of the enucleation techniques in the treatment of large prostates, was slower and required more operation time than HoLEP and OP in terms of total operation time and prostate removal speed. HoLEP seems going to be the fastest candidate for the rapid removal of large prostates in the future.

ABSTRACT Objective To investigate the effect of a 5mg daily tadalafil treatment on the ejaculation time, erectile function and lower urinary tract symptoms (LUTS) in patients with erectile dysfunction. Materials and Methods A total of 60 patients diagnosed with erectile dysfunction were retrospectively evaluated using the international index of erectile function questionnaire-5 (IIEF-5), intravaginal ejaculatory latency time (IELT) and international prostate symptoms scores (IPSS). After the patients were treated with 5mg tadalafil once a day for three months, their erection, ejaculation and LUTS were assessed again. The fasting levels of blood glucose, total testosterone, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and total cholesterol were measured. The independent-samples t-test was used to compare the pre- and post-treatment scores of the patients. Results The mean age of the 60 participants was 50.4±7.9 and the mean baseline serum total testosterone, total cholesterol, and fasting blood sugar were 444.6±178.6ng dL-1, 188.7±29.6mg/dL-1,104 (80-360) mg dL-1, respectively. The mean baseline scores were 2.2±1.4 min for IELT, 9.5±3.7 for IIEF-5 and 14.1±4.5 for IPSS. Following the three-month daily 5mg tadalafil treatment, the scores were found to be 3.4±1.9 min, 16.1±4.7, and 10.4±3.8 for IELT, IIEF and IPSS, respectively. When the baseline and post-treatment scores were compared, a statistically significant increase was observed in the IELTs and IIEF-5 values whereas there was a significant decrease in IPSS (p<0.01). Conclusion A daily dose of 5mg tadalafil can be safely used in the treatment of erectile dysfunction and LUTS, that prolongs the ejaculatory latency time.

This study aimed to measure the serum endocan level of patients with erectile dysfunction (ED) and to investigate the possible association between the Endothelial-specific molecule-1 (Endocan) level and ED. Twenty healthy and sixty-four male patients included in the study were divided into four groups: severe ED (19 patients), moderate ED (24 patients), mild ED (21 patients) and control group (20 healthy men). The erectile function of all the patients was evaluated using the International Index of Erectile Function-5 (IIEF-5) questionnaire. The body mass index (BMI) of each participant was determined, together with levels of fasting blood glucose, total testosterone, low- and high-density lipoprotein cholesterol, triglyceride and endocan in serum samples. No significant difference was found between the three ED groups and the control group in terms of the mean age, BMI and the levels of cholesterol and fasting blood glucose (P>0.05). The mean serum endocan level was found to 1.076±0.5, 0.674±0.40 and 0.671±0.3 ng ml−1 in the severe, moderate and mild ED groups, respectively. This indicated that the highest value was obtained from the severe ED group, and the difference between the severe ED group and the other groups was statistically significant. In the control group, the serum endocan level was 0.73±0.46 ng ml−1, which was significantly higher compared to the moderate and mild ED groups (P<0.05). The significant difference between the control and ED groups in terms of the serum endocan level can assist in the evaluation of endothelial pathologies in the etiology ED.

PURPOSE:The aim of this study is to evaluate expression of deoxyribonucleic acid (DNA) synthesis and repair markers in testicular tissues of azoospermic men in whom sperm retrieval could and could not be achieved as a result of microdissection testicular sperm extraction (micro-TESE) procedure.MATERIALS AND METHODS:In this prospective cohort study, testicular tissues were retrieved from 60 Non-obstructive Azoospermia (NOA) patients who underwent micro-TESE procedure. These patients were divided into twogroups: micro-TESE positive group, which included 30 NOA patients from whom sperm could be extracted via micro-TESE procedure; and micro-TESE negative group, which included 30 NOA patients from whom sperm retrieval could not be achieved via micro-TESE procedure. Expression and distribution patterns of poly(ADP-ribose) polymerase-1 (PARP-1) and proliferative cell nuclear antigen (PCNA) in extracted tissues were assessedby immunohistochemical staining to reveal any differences in DNA synthesis and repair between the two groups.RESULTS:Micro-TESE positive group exhibited significantly stronger immunoreactivity for both PCNA and PARP-1 (P = .001 and P = .001 respectively). The results of this study reveal that both DNA synthesis and repair markers were expressed strongly in patients who experienced successful micro-TESE procedure.CONCLUSION:Although further studies are needed to support these findings, PARP-1 and PCNA expression in testicular tissues of NOA patients could be promising predictive factors for micro-TESE procedure success.

This study was conducted to investigate the prevalence of premature ejaculation (PE) in young Turkish men and to evaluate PE in a population having good physical and mental health. A total of 1230 healthy university graduates aged between 24 and 30 attending the police academy having no physical or mental problems were included in the study. To identify the presence of PE, the participants were asked to complete the premature ejaculation diagnostic tool (PEDT). The mean ages in the PE and non-PE group were 27.3 and 26.7 respectively. There was no statistically significant difference between the two groups concerning age, body mass index (BMI), smoking status and alcohol consumption (P > 0.05). The PE prevalence was found to be 9.2%. The mean PEDT score was calculated as 6.3. Of the participants, 92 scored 11 and higher (9.2%), 66 scored 9 and 10 (6.6%), and the remaining 842 obtained a score equal to or lower than 8 (84.2%). The lower prevalence of PE in young Turkish men compared to the results of studies in the literature can be attributed to the physical and mental well-being of the participants. This study showed that the prevalence of PE in young men with good physical and mental health is lower than that found in the literature.

Objective: Serum prostate-specific antigen (PSA) levels are very important in the diagnosis of prostate cancer. Besides prostate cancer, PSA levels can also be increased by cystoscopy, prostate biopsy, prostatitis, and manipulation. There are also studies reporting that ejaculation affects serum PSA levels. In this study, we aimed to investigate the effects of ejaculation frequency on serum PSA level. Methods: A total of 135 male patients aged in the range of 48–69 years who presented with lower urinary tract symptoms at the urology outpatient clinic between October 2009 and August 2012 were included in the study. Three groups divided according to ejaculation frequency (Group 1, Group 2, and Group 3) were compared by total and free PSA (t/f PSA) values, age, International Prostate Symptom Score (IPSS), prostate volumes, and PSA density (PSAD). Results: There was no significant difference between t/f PSA values, age, IPSS, prostate volumes, and PSAD values of the groups. Conclusion: In our study, ejaculation frequency was found to have no effect on serum PSA levels. (JAREM 2015; 5: 56-9)

42 yaşında kadın hasta sol yan ağrısı yakınması ile kliniğimize başvurdu. Fizik muayenede patolojik bulgu saptanmadı. Özgeçmişinde özellik olmayan hastanın, kan biyokimya parametreleri, tam idrar tahlili ve tam kan sayımı normaldi. Direkt üriner sistem grafisinde; sol böbrekte 3 adet 1 cm boyutunda taş izlendi (Şekil 1). İntravenöz pyelografisinde sol böbrekte lateral rotasyon, üretero pelvik bileşkede darlık ve renal pelviste taşlar saptandı (Şekil 2). DTPA (Dietilen-triamino-penta-asetikasit) sintigrafide sol böbrekte diüretiğe yanıt alınamayan staz saptandı. Preoperatif hazırlığı tamamlanan hasta genel anestezi altında sol u-p darlık tanısıyla ameliyata alındı. Hastanın peroperatif değerlendirmesinde bifid pelvisi olan lateral rotasyone böbrek izlendi (Şekil 3,4). Hastaya dismembred pyeloplasti, pyelolitotomi yapıldı. Postoperatif takibinde herhangi bir problemi olmayan hasta, post-op 3. gün şifa ile taburcu edildi.

This study measured the serum folic acid (FA) level in patients with erectile dysfunction (ED) and evaluated the possible association between the serum FA level and erectile function. The study divided 120 patients with ED into 3 groups of 40 patients each: those with severe, moderate and mild ED. Forty healthy men served as controls. Fasting serum samples were obtained, and the total testosterone, cholesterol and FA levels were measured using chemiluminescent immunoassays. There were no significant differences in the mean age, mean body mass index or mean serum total testosterone and cholesterol levels among the three ED groups and controls (P > 0.05). The mean serum FA concentrations were 7.2 ± 3.7, 7.1 ± 3.2, 10.2 ± 4.6 and 10.7 ± 4.6 ng ml(-1) in the severe, moderate and mild ED and control groups respectively. The mean serum FA concentration was significantly higher in the control group than in the severe and moderate ED groups (both P < 0.001), but not the mild ED group (P = 0.95). Considering the significant differences in the serum FA levels between the control and ED groups, serum FA deficiency might reflect the severity of ED.