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Objective: To detect the prevalence and associated factors of hypogonadism (HG) among men, who were admitted to urology outpatient clinics for reasons other than sexual dysfunction. Materials and Methods: This is a multicentric study designed and conducted by the Turkish Society of Urological Surgery, Andrology Study Group. Male patients between 50 and 75 years of age who were admitted to the urology outpatient clinic for complaints other than sexual dysfunction and whose total testosterone value was measured were included in the study. The correlation between testosterone value and aging male symptoms (AMS) and the international index of erectile function (IIEF) were evaluated. Patient-related factors such as age and comorbidities were also compared between patients with low testosterone values and normal testosterone values. Results: A total of 1021 patients were included in the study. The mean patient age was 69.9±8.6. The most common complaint was non-neurogenic male lower urinary tract symptoms (52.3%). HG prevalence was 38.5% according to the threshold provided in the European Association of Urology guidelines (

Objective: To evaluate the effect of ureteral access sheath (UAS) use and calibration change on stone-free rate and complications of retrograde intrarenal surgery (RIRS). Methods: Data from 568 patients undergoing RIRS for kidney or upper ureteral stones were retrospectively included. Firstly, patients were compared after 1:1 propensity score matching, according to UAS usage during RIRS (UAS used [+] 87 and UAS non-used [−] 87 patients). Then all UAS+ patients (n=481) were subdivided according to UAS calibration: 9.5–11.5 Fr, 10–12 Fr, 11–13 Fr, and 13–15 Fr. Primary outcomes of the study were the success and complications of RIRS. Results: Stone-free rate of UAS+ patients (86.2%) was significantly higher than UAS− patients (70.1%) after propensity score matching (p=0.01). Stone-free rate increased with higher caliber UAS (9.5–11.5 Fr: 66.7%; 10–12 Fr: 87.0%; 11–13 Fr: 90.6%; 13–15 Fr: 100%; p

Introduction: The relationship between inflammation and cancer has long been the focus of researchers' interest. There are many inflammatory markers studied for this purpose in the literature. In this context, we focused on the effects of platelet counts and platelet mass index (PMI) as inflammatory markers in the diagnosis of low-volume localized testicular cancer. Materials and methods: Thirty-eight patients with localized testicular cancer with a mean age of 30.84 ± 5.79 years and 38 patients with varicocele as a control group with a mean age of 32.8 ± 9.7 years were enrolled in the study. Number of platelets, mean platelet volume and value of PMI were calculated from peripheral blood samples obtained. Results: Number of platelets and PMI values were statistically significantly higher in patients with testicular cancer compared with the control group (p

Objective:Ureterorenoscopic stone surgery (USS) is the primary method of ureteral stone treatment. Double-J (JJ) stenting is an integral part of a USS, and most urologists prefer to use it without an extraction string. The probable reason for such preference could be the lack of reliable and sufficient data on JJ stent use with an extraction string.Materials and Methods:A total of 177 patients who underwent USS were divided into four groups: Group 1 men (JJ stent was manually removed), group 2 men (JJ stent was cystoscopically removed), group 3 women (JJ stent was manually removed), and group 4 women (JJ stent was cystoscopically removed). We investigated the impact of two different JJ stent removal techniques on pain perception, lower urinary tract symptoms (LUTS), depressive symptomatology, complications, and cost.Results:Compared to groups 1 and 3, the mean surgery times were higher in groups 2 and 4 (p=0.001). Preoperative LUTS scores were similar in all groups (p>0.05). Postoperative pain scores in groups 3 and 4 were similar (p=0.06), but they were lower in group 1 than in group 2 (p=0.004). Postoperative Beck depression inventory scores were lower in groups 1 and 3 (p

Objective:Acute scrotum is a urological emergency that can result in loss of the testis if the differential diagnosis is not made immediately. Testicular torsion (TT) and epididymo-orchitis (EO) are the two most common causes of acute scrotum. Our aim was to evaluate the utility of haematological parameters for the diagnosis of both TT and EO and for differential diagnosis of these two conditions.Materials and Methods:Data of 98 patients who applied because of acute scrotum between January 2007 and April 2018 were retrospectively analyzed. The patients were divided into three groups: those with TT diagnosis, with EO diagnosis and controls with the diagnosis of other noninflammatory conditions. Demographic data, complete blood count and biochemical parameters at admission were recorded. Values for these parameters along with platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and platelet mass index (PMI) were examined for all groups. The specificity, sensitivity and positive and negative predictive value of parameters that were statistically significant were compared between the groups.Results:Of the 98 patients included in this study, 32 were in the first group, 41 were in the second and 25 were in the third group. The mean neutrophil count in the TT, EO and control groups was 8.7, 7.2 and 5.4, respectively (p=0.001). The mean leukocyte count was 11.8, 10.8 and 8.3 in the TT, EO and control groups, respectively (p=0.003). There was no statistically significant difference in mean lymphocyte count, mean platelet count and PLR, NLR, and PMI between the groups.Conclusion:Although, these tests were insufficient to differentiate TT from EO, we think that they may narrow the indications for emergent exploration for acute scrotum.

Objective:To present our initial experience on laparoscopic transperitoneal nephrectomies and to report the perioperative and postoperative outcomes in patients with kidney tumor.Materials and Methods:We retrospectively evaluated clinical data, laboratory results and radiological findings of 40 patients who underwent laparoscopic renal surgery performed by a single surgeon in a single center between November 2017 and May 2019. Thoracoabdominopelvic computed tomography was performed in all patients.Results:A total of 40 patients (26 males (65%), 14 females (35%) with a median age of 58.7 years underwent laparoscopic transperitoneal nephrectomy. Sixteen patients underwent laparoscopic simple nephrectomy (LSN) for nonfunctional kidney, 20 patients with solid renal tumors underwent laparoscopic radical nephrectomy (LRN), and four patients underwent laparoscopic partial nephrectomy (LPN) for solid renal mass. The mean operative time was 207.9±79.1, 218.9±57.5 and 175.0±75.0 minutes for LSN, LRN and LPN, respectively. The mean length of hospital stays was 3.0±1.3, 2.7±0.6 and 2.7±1.5 days, respectively. Conversion to open surgery was done in 2 patients who underwent LRN and in two patients who underwent LSN due to intraoperative bleeding and intraperitoneal adhesions, respectively. We experienced postoperative complication only in one patient (2.5%) who underwent LSN.Conclusion:Advances in technology and surgical experience have led to an increase in laparoscopic kidney surgery even for advanced renal tumors. Serious complications may occur mainly in the early stages of the learning curve, but complication rates and operative time significantly decrease by the surgeons’ experience. Complicated and more extensive tumors make surgeons more experienced in advanced laparoscopic treatment techniques.

Objective:To analyze the effect of the anesthesia method (spinal and general) on the outcome of ureteroscopy (URS) in patients treated for proximal ureteral stones.Materials and Methods:Patients, who underwent URS for proximal ureteral stones at various urology clinics in Turkiye, were included in the study. The patients were divided into two groups according to the anesthesia method performed; the procedure was performed under spinal anesthesia (SA) in group 1 and general anesthesia (GA) in group 2. Patients’ demographic, perioperative data and complication rates were compared between the two groups in a retrospective manner.Results:There were 309 and 329 patients in groups 1 and 2, respectively. The mean stone area and Hounsfield unit in GA group were higher (p0.05). The rate of success of URS, which is accepted as complete stone-free status, was higher in the SA group (p=0.041).Conclusion:URS, which is used in the treatment of proximal ureteral stones, has a high success rate, independent of the anesthesia method used. It is important to keep in mind the patient’s comorbidities prior to selecting the anesthesia method and that the stone area and the Hounsfield unit are the important factors affecting the outcomes.

Objective:The aim of this study is to compare the efficacy and complications of holmium laser and pneumatic lithotripsy used in the ureterorenoscopic treatment of proximal ureteral stones.Materials and Methods:Data of 638 patients, who underwent ureterorenoscopy (URS) due to proximal ureteral stones in different centers, were obtained from patient files. The patients were divided into two groups according to the type of lithotripter used: group 1; laser lithotripter (n=324; 50.8%) and group 2; pneumatic lithotripter (n=314; 49.2%). URS was considered successful upon determination stone-free status with the imaging methods after treatment. The effectiveness and the complications of holmium:yttrium-aluminum-garnet laser and pneumatic lithotripsy were compared.Results:The total success rate of URS was 82.6% and the complication rate was 8.1%. The mean age of patients was similar between the groups; however, the body mass index values, stone surface area and stone Hounsfield unit were significantly higher in group 1. Although the mean operative time, complication rate and the mean length of hospital stay were similar between the groups; the URS success and postoperative ureteral J stent use rates were significantly higher in group 1 and the push-back rate was significantly higher in group 2.Conclusion:If laser lithotripsy is available in a clinic, we believe that it is better to use it as the first option in the treatment of proximal ureter stones. However, considering that it is not easy to access laser lithotripters due to their high cost in Turkey, pneumatic lithotripters may be an effective and inexpensive alternative that can also be safely used in these cases.

Objective:The aim of this study is to investigate the association of preoperative platelet mass index (PMI) with tumor pathologic features and postoperative biochemical recurrence in patients undergoing radical prostatectomy due to localized prostate cancer.Materials and Methods:Data of 141 patients, who underwent radical prostatectomy for localized prostate cancer between April 2004 and April 2017, were retrospectively screened. Patient age, preoperative prostate-specific antigen (PSA) level, platelet count, mean platelet volume and PMI value, neutrophil-lymphocyte ratio (NLR), tumor grade, Gleason score, tumor volume, lymph node involvement, surgical margin positivity and biochemical recurrence at 3 months were all noted. The relationship of preoperative PMI value with age, PSA, pathologic parameters, surgical margin positivity and biochemical recurrence was evaluated.Results:The mean age of the patients was 61.79±5.98 years, the mean PSA value was 9.50±6.69 ng/mL, mean PMI was 2003.91±486.69, and the mean NLR was 2.79±2.06. There was no correlation of PMI value with PSA, pathological stage, Gleason score, lymph node involvement, tumor volume, surgical margin positivity, and biochemical recurrence. There was statistically significant negative correlation between PMI and Gleason score.Conclusion:In our study, we could not demonstrate preoperative PMI as a prognostic factor for early biochemical recurrence in patients undergoing radical prostatectomy for prostate cancer. To achieve a better conclusion that we can generalize, there is a need for prospective studies with larger patient series.