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Objective: We aimed to investigate the long-term surveillance outcomes (biochemical recurrance, survival) and adequacy of active surveillance criteria to detect low-risk prostate cancer patients who were eligible for active surveillance but underwent radical prostatectomy. Materials and Methods: Data of patients who underwent radical prostatectomy for prostate cancer between January 2005 and January 2019 were retrospectively evaluated. Upstaging, upgrading, surveillance periods, and survival status of patients with clinical stage T1c and T2a, serum prostate-specific antigen below 10 ng/mL, International Society of Urological Pathology grade 1, number of tumor-positive cores in biopsy 2 and below, tumor percentage in tumor-positive cores 50 and below were inclusion criteria for active surveillance. Results: The study included 606 patients. Of these patients, 184 (30.4%) met the inclusion criteria for active surveillance. Upgrading was detected in 77 (41.8%) patients and upstaging in 29 (15.8%) patients who met the criteria for active surveillance. The prostate-specific antigen (PSA) and PSA density values of the patients who met the active surveillance criteria were significantly lower than those of the other patients (p<0.05). The mean surveillance period was 127.6±49.6 (8-227) months, and 123 patients died during this period. Among them, 18 (3%) patients died because of related causes of prostate cancer. None of the patients who met the criteria for active surveillance died because of prostate cancer (p=0.018). Conclusion: No cancer-related deaths were observed in patients who is eligible for active surveillance but underwent radical prostatectomy. This may suggest that active surveillance criteria are suitable for detecting low-risk prostate cancer patients. [ABSTRACT FROM AUTHOR]

Objective: Diagnoses of variant histopathology (VH) in bladder cancer (BC) are increasing, and although there is a standard treatment algorithm for BC, the guidelines lack a standardized approach for treating VH in BC. We aimed to compare the survival results of the treatment algorithm applied to patients with BC with VH in the first transurethral resection of the bladder (TUR-B) procedure. Materials and Methods: We retrospectively assessed data on patients with VH of BC in the first TUR-B between January 2000 and January 2021. After the first TUR-B, we determined TUR-B+/-BCG, radical cystectomy (RC), and trimodal therapy (TMT) as the three potential treatments for patients according to the initial plans applied by the clinics. Results: A total of 289 patients with VH of BC in the first TUR-B were included in the study. Their mean age was 66.7±10.1 years, and most (246, 85.1%) were male. We found that TMT was associated with lower survival, and BCG administration offered no advantage in terms of overall survival (OS) or cancer specific survival (CSS) among patients with non-muscle-invasive bladder cancer (NMIBC). In patients with MIBC, immediate RC provided a significant advantage over other treatment methods in terms of both OS and CSS. Conclusions: There is still no standard treatment for patients with VH of BC. Patients are less likely to survive TMT than other treatment modalities. [ABSTRACT FROM AUTHOR]

Objective: To present the postoperative and oncological outcomes of patients diagnosed with unclassified renal cell carcinoma (uRCC). Materials and Methods: Radiological and pathological data of patients who underwent radical nephrectomy for renal tumour diagnosed with uRCC according to histopathologic evaluation were investigated between 2006 and 2013. Follow-up data, such as metastasis-free and overall survivals, were also evaluated. Patients' characteristics and data were compared between localised tumour (T1-T2) and locally invasive tumour (T3-T4) groups and metastasis positive and negative groups during follow-up, separately. Results: A total of 17 patients participated in the study, wherein 7 had adrenalectomy in addition to radical nephrectomy and 3 had lymph node dissection. The mean tumour diameter was 91.9±44 mm (30-200 mm), and seven patients were pathologically T3a, two were T3b and one patient had T4 tumour, whereas eight had Fuhrman grade 4 and five had Fuhrman grade 3 tumours. Pathologically, seven patients had tumours with sarcomatoid features, whereas four had microvascular invasion and seven had renal sinus invasion. T-stage correlated with renal sinus invasion and was identified as an important factor in metastasis progression. The overall survival time was observed to be low in locally invasive and metastasis positive groups. Nevertheless, differences were not statistically significant. In the investigation of factors affecting metastasis development, microvascular invasion and renal sinus invasion were significant. Conclusion: The study revealed more aggressive nature (advanced stage, bigger tumour, more aggressive histopathological features and more metastasis and shorter survival on follow-up) of uRCC tumours, even without obtaining statistically significant differences. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to investigate the oncologic outcomes of patients who were diagnosed with primary (muscle invasive cancer at the time of diagnosis) and secondary (cancer that showed progression from non-muscle invasive bladder cancer) muscle invasive bladder carcinoma (MIBC) before radical cystectomy (RC). Materials and Methods: Patients who underwent RC at our clinic for MIBC between July 2008 and June 2017 were included in the study. They were divided into two groups based on their diagnosis as primary and secondary MIBC. Their clinical, pathological, and oncologic data (upstaging, adjuvant chemotherapy, overall mortality, overall survival, cancer-specific mortality, and cancer-specific survival) were evaluated retrospectively. Results: A total of 80 patients underwent RC due to bladder cancer with a mean age of 64.4±7.8 years (range: 42-83 years) and a mean follow-up time of 32.9±32.1 months (range: 1-113 months). The overall and cancer-specific survivals of the patients were 64.7±6.6 and 74±6.8 months, respectively. Sixty-five and 15 patients were evaluated in the primary and secondary MIBC groups, respectively. Lymph node metastasis was higher in primary MIBC group (p=0.031). Although, there were no statistical differences between the groups, in secondary MIBC group, the overall survival (67.3±7.2 months vs 42.5±8.4 months; p=0.835) and cancerspecific survival (77.6±7.4 months vs 46.6±8.6 months; p=0.546) were lower, while the overall mortality (44.6% vs 53.3%; p=0.372) and cancer-specific mortality (32.3% vs 46.7%; p=0.293) were higher compared to primary MIBC group. Conclusion: The pre- and postoperative pathological T stages were similar between the groups, whereas postoperative lymph node positivity was lower for secondary MIBC patients. The mortality was higher and overall and cancer-specific survivals were lower in secondary MIBC patients; however, these findings were not statistically significant. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the influence of preoperative factors on postoperative renal function and the association between renal function and oncologic outcomes and complications after radical cystectomy (RC). Materials and Methods: We retrospectively analyzed patients who underwent RC due to muscle-invasive bladder cancer and intravesical treatmentresistant nonmuscle-invasive bladder cancer in our center between January 2006 and March 2017. The patients' age, gender, comorbidities, preoperative estimated glomerular filtration rate (eGFR), presence of hydronephrosis, hydronephrosis grade and laterality, urinary diversion type, preoperative and postoperative pathology findings, eGFR at postoperative 3rd month, oncologic outcomes, and complication rates were evaluated. The patients were divided into 2 groups based on postoperative eGFR: group 1 (<60 mL/min eGFR) and group 2 (=60 mL/min eGFR), and data were compared between the groups. Results: The study included 125 patients with urothelial carcinoma of the bladder who underwent RC and had complete records (59 patients in group 1 and 66 patients in group 2). Of the preoperative factors, only presence of hydronephrosis was significantly higher in group 1 (p=0.012). There were no statistically significant differences between the groups in terms of urinary diversion type, pathology findings, oncologic outcomes, or complications. Conclusion: Preoperative eGFR and hydronephrosis were significantly associated with postoperative 3rd month eGFR. Postoperative eGFR <60 mL/min was not associated with diversion type, pathologic and oncologic outcomes, or complications. [ABSTRACT FROM AUTHOR]

Perivascular epithelioid cell tumors are rare mesenchymal tumors composed of histologically and immunohistochemically distinctive perivascular epithelioid cells. They are mostly benign, however, malignant tumors with aggressive behavior and distant metastasis can also occur. The standard treatment is surgical excision. Here, we report a case of a 25-year-old male with a 4 cm-mass located in the inferior pole of the left kidney, treated by surgical excision. [ABSTRACT FROM AUTHOR]

Objective Partial nephrectomy represents the gold standard surgical procedure for the treatment of small renal cortical tumors. Tumor resection may be performed with the following techniques: on-clamp (warm or cold ischemia) and off- clamp (zero-ischemia). We aimed to share our experience with these two techniques and compare treatment outcomes in the present study. Materials and Methods Patients who have undergone open partial nephrectomy for clinical stage I renal cell carcinoma in our department between 2008 and 2012 were enrolled. Group 1 comprised patients with off-clamp technique and group 2 with on-clamp technique. Demographic data, length of operation, length of hospitalization, preoperative estimated glomerular filtration rate (eGFR) and postoperative eGFR on the last visit, complications and requirement of additional procedures, pathologic stage, and surgical margin status were compared between the groups retrospectively. Results A total of 73 patients, 40 in group 1 and 33 in group 2, were included in the study. Mean age, rate of comorbidities, R.E.N.A.L. nephrometry scores, preoperative eGFR, length of operation, length of hospitalization, complications, surgical margin status and additional procedure requirement did not differ significantly between the groups. Transfusion requirement was higher in group 1, however, it did not reach statistical significance (0.7±1.2 U vs. 0.2±0.5 U, p=0.066). After a median follow-up of 27 months for group 1 and 33 months for group 2, postoperative eGFR values were also similar (72.6±31.0 ml/min/1.73 m2 vs. 78.3±22.3 ml/min/1.73 m2, p=0.651). Conclusion Both surgical techniques, on-clamp and off-clamp partial nephrectomy, can be performed according to the surgeons' preferences safely with similar outcomes. [ABSTRACT FROM AUTHOR]

Objective In this study, we aimed to present clinical characteristics and repair outcomes in patients who had sexual intercourse-induced penile trauma and underwent early surgical repair in our clinic. Materials and Methods We retrospectively evaluated records of patients who underwent early surgical repair due to penile trauma between 2004 and 2014 in our clinic. Preoperative, peroperative and postoperative data were analyzed. Patient characteristics, penile trauma characteristics, pre-trauma and postoperative International Index of Erectile Function-Erectile Function Domain Scores (IIEF-ED), and operation features were evaluated. Results Twenty-six male patients who were admitted to the emergency room with penile trauma and underwent early surgical repair were investigated. Four patients had only dorsal vein laceration and twenty-two had corpus cavernosum rupture. Postoperative erectile dysfunction was observed in three patients (the patients were older than 45 years of age, a patients had bilateral corpus cavernosum rupture and two patients had concomitant urethral trauma). Early repair was successful (86.4%) in the remaining 19 patients. The average erection hardness grade and IIEF-ED value were 4.75 and 28.6 before penile fracture; postoperative mean erection hardness grade and IIEF-ED value were found to be 4.2 and 24.9, respectively (p>0.05). Conclusion As a result, in sexual intercourse-induced penile fracture, early repair with degloving approach is effective method in postoperative erectile success in young patients and patients with isolated unilateral fractures. [ABSTRACT FROM AUTHOR]