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Percutaneous nephrolithotomy (PCNL) is a widely preferred method for treating complex kidney stones, particularly in patients with larger or more complicated stones. Despite its advantages, such as minimal invasiveness and a shorter recovery time, postoperative complications can occur, thereby necessitating effective risk assessment tools to identify at-risk patients. This study evaluated the Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system's utility in predicting postoperative complications following standard PCNL. This retrospective study included 218 patients who underwent standard PCNL from June 2020 to August 2024 at our institution. Data on demographics, comorbidities, and perioperative factors were collected and analyzed. Postoperative complications were classified using the modified Clavien-Dindo system. The E-PASS scoring system, which incorporates the Preoperative Risk Score (PRS), Surgical Stress Score (SSS), and Comprehensive Risk Score (CRS), was applied to stratify risk. Postoperative complications occurred in 38 patients (17.4%). Significant predictors included advanced age, higher American Society of Anesthesiologists (ASA) scores, and comorbidities like diabetes and coronary artery disease. Intraoperative factors, such as prolonged operative times, number of access and greater blood loss, were also associated with complications. Multivariate analysis identified higher CRS and greater stone burden as independent predictors (p = 0.012 and p = 0.037, respectively). The CRS demonstrated moderate discrimination, with an area under the curve (AUC) of 0.747. The E-PASS scoring system effectively predicts postoperative complications in PCNL, underscoring the importance of thorough preoperative and intraoperative evaluation. Future studies should explore its broader applicability across other urological procedures., Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: To evaluate and compare continuous suture (CS) and interrupted suture (IS) techniques applied in excision and primary anastomosis (EPA) urethroplasty in terms of surgical success and complication rates., Methods: A retrospective evaluation was conducted on patients with bulbar urethral strictures measuring ≤ 2.5 cm who underwent EPA between April 2020 and December 2022. Patients with a history of urethral reconstruction, multiple strictures, a history of pelvic radiotherapy, a diagnosis of Lichen sclerosis, a history of surgery due to congenital penile curvature or Peyronie's disease, and a follow-up period of less than 12 months were excluded. The patients were divided into two groups according to the suture technique used (CS or IS), and the groups were compared for demographic and perioperative data., Results: A total of 97 patients (CS n = 52, IS n = 55) were included in the sample. The mean age of the entire patient group was calculated to be 56.2 years and the mean stricture length was 19.3 mm. Operation time and postoperative catheter time were shorter in the CS group (94.7 ± 7.3 vs. 117.2 ± 5.7 min and 9.9 ± 1.6 vs. 15.8 ± 1.9 min, p < 0.001, respectively). The groups were similar regarding anatomical success, stress urinary incontinence, penile numbness, curvature, and postoperative infection (p > 0.05)., Conclusion: No significant difference was observed in terms of success or complications between the CS and IS techniques employed during EPA urethroplasty. However, in addition to reducing the operation time, the CS technique offers the advantage of safely removing the urethral catheter earlier., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Mini-percutaneous nephrolithotomy (MPCNL), which has a smaller tract size (14-20 Fr) than conventional percutaneous nephrolithotomy, has been shown to be safe and effective in pediatric patients with large and complex upper urinary tract stones. This study aimed to compare the efficacy and safety of MPCNL between the supine and prone positions in a pediatric population. The data of pediatric patients who underwent MPCNL at our center between January 2010 and March 2023 were retrospectively analyzed. According to the surgical position, the patients were divided into the prone (Group P) and supine (Group S) groups. In both groups, dilatation was performed using 14-18 Fr metallic dilators. The two groups were compared in terms of perioperative data, postoperative stone-free rates (SFRs), and complications. There were 36 (59%) patients in Group P and 25 (41%) patients in Group S. Stones were mostly located in the pelvis (49.2%) and second most frequently in the lower pole (27.9%). Fluoroscopy time was shorter in Group S but did not statistically significantly differ compared to Group P (p = 0.181). However, operation time was statistically significantly shorter in Group S (73.8 ± 35 vs. 99.8 ± 37.4 min, p = 0.008). Although there was no significant difference, relatively higher SFR were detected in Group S (88% vs. 83%, p = 0.725). Endoscopic combined intrarenal surgery (ECIRS) was performed on six (24%) patients in Group S, and the SFR was 100% among these patients. There was no significant difference between the two groups in terms of the presence of complications (16.7% vs. 16%, p = 0.945). Both supine and prone MPCNL appear to be safe and effective in the pediatric age group, with similar stone-free and complication rates. In the supine procedure, the operation time is shortened compared to the prone. In addition, simultaneous retrograde access has the potential to increase the overall success rate of surgery., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: One of the underlying reasons for shock wave lithotripsy (SWL) resistance is the ureteral stone impaction. This study aimed to investigate the accuracy of the hypothesis, suggesting that SWL per se can be the reason for ureteral stone impaction., Methods: One hundred and seventy-six patients were enrolled in the study. Data of the patients (N.=50) treated with SWL and subsequent semirigid ureteroscopic laser lithotripsy (SULL) in our center between January 2014 and January 2020 were retrospectively reviewed compared with the data of the patients (N.=126) who underwent SULL without prior SWL treatment during the same period. Patients reported to have ureteral stone impaction during SULL were compared with those without stone impaction in terms of demographic parameters, stone characteristics and clinical data, including symptom duration and presence or absence of SWL history., Results: The success rate of SULL was determined as 80.1% (141/176). Univariable analysis revealed statistically significant differences between the patients with and without stone impaction concerning stone diameter, stone volume, pre-SULL SWL history, symptom duration and ureteral wall thickness (UWT). Multivariable logistic regression analysis revealed that symptom duration and UWT were independent predictive factors for ureteral stone impaction., Conclusions: Symptom duration and UWT are independent predictors of ureteral stone impaction. Symptom duration and UWT should be considered during treatment planning and informed consent process before proceeding with SULL.

Objectives: To compare autologous transobturator-tape (A-TOT) and autologous transvaginal tape (A-TVT) surgeries in terms of effectivity and complications., Material and Methods: Preoperative data, duration of the operation, complications and postoperative visual analogue scores were noted. Patients were assessed 12 months after surgery. An objective cure was defined as a negative CST and no need for reoperation due to SUI. Subjective cure was defined as a PGI-I score ≤ 2. Symptom severity and QoL were measured using the total score and the total QoL score of the ICIQ-FLUTS., Results: Retrospectively 44 patients (A-TOT:29, A-TVT:15) were enrolled in this study. Mean follow-18 months. Preoperative parameters were similar. The VAS score at the 8th hour postoperatively was higher in the A-TOT group and similar at the 24th h (p = 0.007 and p = 0.587, respectively). Grade 3 complications according to clavien dindo were only observed in the A-TOT group. At 12 month the objective cure rates according to CST were 96.5% and 100 the subjective cure rates according to PGI-I veew 96.5% and 100%. A positive CST findingwasrecorded in one patient (3.3%) in the A-TOT group. Total score and total quality of life (QoL) scores on the ICIQ-FLUTS were found to be significantly improved in both groups (p = 0.001 and p = 0.001, respectively) (Tab. 4). Similar improvements were found in both groups in the overall and quality of life subscores of the ICIQ-FLUTS filling and voiding sections (p = 0.476, p = 0.315, p = 0.520, and p = 0.448, respectively)., Conclusions: The A-TOT technique has objective, subjective cure, and overall complication rates comparable to those of the A-TVT technique. The use of autologous fascia provides an opportunity to avoid mesh-related complications.

Purpose: To compare the models developed with a classical statistics method and a machine learning model to predict the possibility of orchiectomy using preoperative parameters in patients who were admitted with testicular torsion., Materials and Methods: Patients who underwent scrotal exploration due to testicular torsion between the years 2000 and 2020 were retrospectively reviewed. Demographic data, features of admission time, and other preoperative clinical findings were recorded. Cox Regression Analysis as a classical statistics method and Random Forest as a Machine Learning algorithm was used to create a prediction model., Results: Among patients, 215 (71.6%) were performed orchidopexy and 85 (28.3%) were performed orchiectomy. The multivariate analysis revealed that monocyte count, symptom duration, and the number of previous Doppler ultrasonography were predictive of orchiectomy. Classical Cox regression analysis had an area under the curve (AUC) 0.937 with a sensitivity and specificity of 88 and 87%. The AUC for the Random Forest model was 0.95 with a sensitivity and specificity of 92 and 89%., Conclusion: The ML model outperformed the conventional statistical regression model in the prediction of orchiectomy. The ML methods are cheap, and their powers increase with increasing data input; we believe that their clinical use will increase over time., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: To develop a model for predicting biochemical recurrence (BCR) in patients with long follow-up periods using clinical parameters and the machine learning (ML) methods., Materials Method: Patients who underwent robot-assisted radical prostatectomy between January 2014 and December 2019 were retrospectively reviewed. Patients who did not have BCR were assigned to Group 1, while those diagnosed with BCR were assigned to Group 2. The patient's demographic data, preoperative and postoperative parameters were all recorded in the database. Three different ML algorithms were employed: random forest, K-nearest neighbour, and logistic regression., Results: Three hundred and sixty-eight patients were included in this study. Among these patients, 295 (80.1%) did not have BCR (Group 1), while 73 (19.8%) had BCR (Group 2). The mean duration of follow-up and duration until the diagnosis of BCR was calculated as 35.2 ± 16.7 and 11.5 ± 11.3 months, respectively. The multivariate analysis revealed that NLR, PSAd, risk classification, PIRADS score, T stage, presence or absence of positive surgical margin, and seminal vesicle invasion were predictive for BCR. Classic Cox regression analysis had an area under the curve (AUC) of 0.915 with a sensitivity and specificity of 90.6% and 79.8%. The AUCs for receiver-operating characteristic curves for random forest, K nearest neighbour, and logistic regression were 0.95, 0.93, and 0.93, respectively. All ML models outperformed the conventional statistical regression model in the prediction of BCR after prostatectomy., Conclusion: The construction of more reliable and potent models will provide the clinicians and patients with advantages such as more accurate risk classification, prognosis estimation, early intervention, avoidance of unnecessary treatments, relatively lower morbidity and mortality. The ML methods are cheap, and their powers increase with increasing data input; we believe that their clinical use will increase over time., (© 2021 Wiley Periodicals LLC.)

This study tested the levels and consequences of positive religious coping among a multinational sample of Muslims. The sample consisted of 706 university students recruited in three Muslim countries: Israel/Palestine, Turkey and Malaysia. Participants' average age was 22.61, and 65% of them were females. This investigation applied a cross-sectional comparative methodology. Measures used: demographics, positive religious coping, satisfaction with life and depressive symptoms. The findings indicated that (a) participants reported high levels of positive religious coping usage, and Malaysians scored significantly higher in this regard than both Palestinians and Turks; (b) positive religious coping correlated positively with satisfaction with life but was not linked to depressive symptoms and (c) the magnitude of correlation between positive and satisfaction with life was significantly higher among Malaysians than among both Palestinians and Turks. The findings suggest that to understand the implications of positive religious coping for the health and well-being of Muslims, a detailed and nuanced analysis is needed., (© 2018 International Union of Psychological Science.)

This investigation applied a cross-sectional comparative methodology to examine the levels, predictors, and consequences of religious struggles among a multinational sample of 706 Muslims recruited in three universities in Israel/Palestine, Turkey, and Malaysia. Participants were asked to provide demographics and complete measures of religious struggles, satisfaction with life, and generalized anxiety. Three main findings emerged from the study: (1) In general, participants reported low levels of religious struggles; (2) Turks scored significantly higher than both Palestinians and Malaysians on religious struggles; (3) higher levels of generalized anxiety were predicted by higher levels of religious struggles among Malaysians only, and lower levels of satisfaction with life were predicted by higher levels of religious struggles among Palestinians and Turks only. These findings suggest that the links between religious struggles and health and well-being among Muslims are complex, and call for a nuanced detailed analysis of the religious struggles phenomenon among this population.