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Introduction: In this study, we aimed to explore using the predictive role of systemic immune inflammation index (SII) for responses of intravesical Bacillus Calmette-Guérin (BCG) therapy in patients with intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC). Methods: From 9 centers, we reviewed the data of patients treated for intermediate- and high-risk NMIBC between 2011 and 2021. All patients enrolled in the study presented with T1 and/or high-grade tumors on initial TURB had undergone re-TURB within 4–6 weeks after initial TURB and had received at least a 6-week course of intravesical BCG induction. SII was calculated with the formula SII = (P × N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively. In patients with intermediate- and high-risk NMIBC, the clinicopathological features and follow-up data were evaluated to compare SII with other systemic inflammation-based prognostic indices. These included the neutrophil-to-lymphocyte ratio (NLR), platelet-to-neutrophil ratio (PNR), and platelet-to-lymphocyte ratio (PLR). Results: A total of 269 patients were enrolled in the study. Median follow-up time was 39 months. Disease recurrence and progression were observed in 71 (26.4%) and 19 (7.1%) patients, respectively. For groups with and without disease recurrence in terms of NLR, PLR, PNR, and SII calculated prior to intravesical BCG treatment, no statistically significant differences were observed (p = 0.470, p = 0.247, p = 0.495, and p = 0.243, respectively). Moreover, there were also no statistically significant differences between the groups with and without disease progression in terms of NLR, PLR, PNR, and SII (p = 0.504, p = 0.165, p = 0.410, and p = 0.242, respectively). SII did not show any statistically significant difference between early (p = 0.492) and progression groups (p = 0.216). Conclusion: For patients with intermediate- and high-risk NMIBC, serum SII levels do not present as an appropriate biomarker for the prediction of disease recurrence and progression following intravesical BCG therapy. A possible explanation for the failure of SII to predict BCG response may be found in the impact of Turkey’s nationwide tuberculosis vaccination program.

WOS: 000464095200008, Nanomedicine is a branch of nanotechnology that includes the development of nanostructures and nanoanalytical systems for various medical applications. The rapid development of nanomedicine offers new possibilities in cancer diagnosis and treatment. New therapeutic strategies in cancer research using nanoparticles are being developed in order to improve the specificity and efficacy of drug delivery, thus reaching maximal effectiveness with minimal side effects. Due to its selective overexpression in prostate cancer (PCa), prostate-specific membrane antigen (PSMA) has been recognized as a highly promising target for diagnostic and therapeutic applications. This review provides an update on the PSMA-based nanomedicine applications in PCa.

Retroperitonealsarkomlar tüm yumu­şak doku sarkomlarının % 15’ini oluşturan nadir tümörlerdir.Sıklıkla insidental olarak tanı alan retroperitoneal sarkomlarda en sıkrastlanan histolojik tip liposarkomdur. Ret­roperitoneal liposarkomlarda yaşamsüresini uzatan majör tedavi şekli geniş cerrahi re­zeksiyondur. Cerrahisonrası lokal rekürrens ve metastaz riskinden dolayı bu hastalarınmultidispliner olarak uzun dönem takip edil­meleri gerekmektedir. Burada ilkoperasyo­nu sonrası takipsiz kalan ve 16 yıl sonra 24 cm’lik devretroperitoneal kitle ile başvuran 72 yaşındaki bir liposarkom olgusuna yakla­şımımızısunduk., Retroperitoneal sarcomas are rare tumors and form 15% of all soft tissue sarcomas. The most common histologic type ofretroperitoneal sarcomas is liposarcoma,which are frequently diagnosed incidentally.Major treatment in retroperitoneal liposarcoma is extensive surgical resection. Because ofthe risk of local recurrence and metastasis after surgery, these patients should be followedup by multidiciplinary for a long time. Postoperative follow-up of the patients should bemultidisciplinary.Herein we presented our approach to a72-year-old liposarcoma case, who was admitted without follow-up after the first ope-ration and was presented with a giant retro-peritoneal mass of 24 cm 16 years later.

Object: We aimed to investigate the effect of preoperative nephrostomy or double J stent insertion on infectious outcomes in patients undergoing percutaneous nephrolithotomy. Materials and Methods: A total of 652 patients who underwent percutaneous nephrolithotomy between January 2012 to January 2016 in our clinic included in this study. There were three groups. Group 1 included 585 patients who underwent concurrent percutaneous renal access during PCNL, group 2 included 34 patients who had nephrostomy drainage before PCNL and group 3 included 33 patients in whom renal pelvis drainage was established with D-J catheter before PCNL operation. Preoperative urine culture, preoperative nephrostomy culture, intraoperative renal pelvis culture, stone culture and postoperative fifteenth day urine culture were obtained from all patients. WBC counting performed preoperative and postoperative first day and followed daily for patients with fever. All patients were followed up postoperatively for signs of systemic inflammatory response syndrome (SIRS) and sepsis. Results: Positive preoperative urine culture and positive postoperative 15th day urine culture was significantly higher in preoperative nephrostomy group. There was no significant difference between the groups in terms of SIRS and sepsis. Hospitalization time is the only factor for postoperative SIRS. Postoperative nephrostomy time, hospitalization time, preoperative (+) urine culture, positive stone culture and irrigation volume was found to be the risk factors for postoperative sepsis. Conclusion: We found that preoperative nephrostomy drainage or preoperative double j stenting does not affect postoperative sepsis and postoperative SIRS in patients undergoing percutaneous nephrolithotomy., Amaç: Perkütan nefrolitotomi yapılan hastalarda preoperatif nefrostomi ve double j stent yerleştirilmesinin infeksiyöz sonuçlara etkisini değerlendirmek. Gereç ve Yöntemler: Kliniğimizde Ocak 2012-Ocak 2016 arasında perkütan nefrolitotomi yapılan 652 hasta çalışmaya dahil edildi. Hastalar 3 gruba ayırıldı. Grup 1 de preoperatif herhangi bir stent veya nefrostomi takılmayan 585 hasta, grup 2’de PNL öncesi nefrostomi takılan 34 hasta, grup 3’de ise PNL öncesi double j stent takılan 33 hasta vardı. Preoperatif idrar kültürü, preoperatif nefrostomi kültürü, intraoperatif renal pelvis kültürü, taş kültürü ve postoperatif 15. gün idrar kültürü tüm hastalardan alındı. WBC sayımı preoperatif ve postoperatif 1. gün tüm hastalara, postoperatif ateşi olan hastalara ise günlük olarak yapıldı. Bütün hastalar postoperatif dönemde sistemik inflamatuar cevap sendromu(SIRS) ve sepsis bulguları açısından takip edildi. Bulgular: Preoperatif nefrostomi takılan grupta preoperatif idrar kültürü ve postoperatif 15.gün idrar kültürü anlamlı olarak daha yüksekti. Sepsis oranları grup 1, 2 ve 3’de sırasıyla %3,4, %5,8 ve %6,1 idi. Gruplar arasında SIRS ve sepsis gelişimi açısından anlamlı fark izlenmedi. Hastanede kalış süresi SIRS gelişimi açısından tek risk faktörü olarak bulundu. Postoperatif nefrostomi süresi, hastanede kalış süresi, preoperatif pozitif idrar kültürü, pozitif taş kültürü ve irrigasyon volümü postoperatif sepsis gelişmesi açısından risk faktörleri olarak bulundu. Sonuç: PNL yapılan hastalarda, postoperatif sepsis gelişiminde preoperatif olarak takılan nefrostominin veya double j stent yerleştirilmesinin etkisi yoktur.

GİRİŞ ve AMAÇ: Bu çalışmada TRUS-PBx’deki ağrı skorları ile hastaların beden kitle indeksleri (BKİ) arasındaki ilişki araştırılmıştır.YÖNTEM ve GEREÇLER: Ekim 2014-Nisan 2015 arasında anormal parmakla rektal muayene bulgusu ve/veya yüksek prostat spesifik antijen (PSA) düzeyi (≥2,5 ng/ml) nedeniyle TRUS-PBx yapılan toplam 198 hasta çalışmaya dâhil edildi. Biyopsi öncesinde tüm hastalara 10 ml %2 prilokainle transperineal periprostatik sinir blokajı uygulandı. Ağrı skorları 10’luk lineer vizüel analog skala (VAS) kullanılarak, ultrason probu rektuma yerleştirildikten hemen sonra (VAS-1) ve biyopsi esnasında iğne girişi sırasında (VAS-2) ağrı düzeyi değerlendirildi. BKİ’ye göre hastalar 2 gruba ayrıldılar: Grup-1 (n=156) BKİBULGULAR: Hastaların ortalama yaşı 64±7.3 yıl ve ortalama PSA değeri 12.5±18.3 ng/dl idi. Prostat kanseri tespit oranı %22.7 idi. Grup-1’deki hastaların VAS-1 skoru grup-2’dekilerden yüksek olmakla birlikte (1.8±2.1 vs 1.3±1.6), aradaki fark istatistiksel olarak anlamlı değildi (p=0.123). Diğer yandan, ortalama VAS-2 skorları grup-1’de 2.7±2.6, grup-2’de 1.9±1.7 idi ve aradaki fark istatistiksel olarak anlamlıydı (p=0.026).TARTIŞMA ve SONUÇ: BKİ düşük olan hastalar TRUS-PBx işleminde prostat örneklemesi sırasında daha fazla ağrı hissetmektedirler. Bu hastaların konforunu artırmak için alternatif anestezi teknikleri göz önünde bulundurulmalıdır., INTRODUCTION: In this study we assessed the relationship between pain scores during transrectal ultrasound-guided prostate biopsy (TRUS-PBx) and body mass index (BMI) of the patients. METHODS: Between October 2014-April 2015, 198 patients who underwent prostate biopsy with abnormal digital rectal examination findings and/or high PSA levels (≥2,5 ng/ml) were included in this study. Before the biopsy procedure, all patients underwent transperineal periprostatic block with 10 mL of 2% prilocaine. A 10-point linear visual analogue scale (VAS) was used to assess the pain arising from probe insertion (VAS-1) and prostate sampling (VAS-2). According to BMI, patients were divided into 2 groups: Group-1 (n=156) included BMIRESULTS: The mean age of the patients was 64±7.3 years, and the mean PSA value was 12.5±18.3 ng/dl. Prostate cancer detection rate was 22.7%. VAS-1 score was higher in group-1 than group-2 (1.8±2.1 vs 1.3±1.6), however, the difference was not statistically significant (p=0.123). The mean VAS-2 scores were 2.7±2.6 in group-1 and 1.9±1.7 in group-2 and the difference was statistically significant (p=0.026).DISCUSSION AND CONCLUSION: Patients with a low BMI feel more pain at the time of prostate sampling during TRUS-PBx. In these patients alternative anesthesia techniques can be considered in order to increase the patients’ comfort.

Objective: It was aimed to evaluate the incidence of prostate adenocarcinoma in patients treated by cystoprostatectomy for invasive bladder urothelial carcinoma and to demonstrate the histopathological features of prostate cancer cases.

Objectives: Shock wave lithotripsy SWL is a simple, effective, and minimally invazive treatment option for urinary tract stone disease. Nevertheless, pain during the SWL procedure is one of the most common restriction factor for this treatment modality.We aimed to compare the efficacy and adverse effects of intravenous IV paracetamol and oral tablet tramadol for pain control during SWL procedure. Material and Methods: We enrolled 54 patients with the indication of SWL therapy in this prospective randomized comparative study. 1 g IV paracetamol infusion was applied to group I n:28 and 100 mg oral tramadol was applied to group II n:26 . The pain was measured by 10-point visual analog scale VAS . 1 mg/kg of body weight intramuscular pethidine meperidine was applied when supplemental analgesia required. Results: The mean VAS score was significantly lower in group I patients than in group II at 5, 10, 15, 30, 40th minutes during lithotripsy P=0.011, P=0.009, P=0.001, P=0.000, P=0.000, respectively . Supplementary analgesic requirement was higher in group I than group II which received more shockwaves or higher voltages. However, this difference was not statistically significant P=0.199 . Conclusions: This is the first study comparing the analgesic effects of IV paracetamol and oral tramadol for pain control during SWL in the literature. IV paracetamol provides better analgesia than oral tramadol with minimal side effects. However, a minimal increase in supplemental analgesia requirement should be considered in patients who will receive more shockwaves or higher voltages, Amaç: Şok dalga litotripsi SWL üriner sistem taş hastalığının tedavisinde kolay, etkili ve minimal invaziv bir tedavi seçeneğidir. Bununla beraber, SWL işlemi sırasında hastanın duyduğu ağrı bu tedavi seçeneğini kısıtlayan en önemli faktördür. SWL işlemi sırasındaki ağrının kontrolü için intravenöz IV parasetamol ile oral tablet tramadolün etkinliğini ve yan etkilerini karşılaştırdık. Gereç ve Yöntemler: Bu prospektif randomize karşılaştırmalı çalışmaya SWL tedavisi endikasyonu olan 54 hasta dahil edildi. Grup I n:28 ’ deki hastalara 1 g IV parasetamol infüzyonu uygulanırken grup II n:26 ’ deki hastalara 100 mg oral tramadol verildi. Ağrı düzeyi 10’luk vizüel analog skala VAS ile ölçüldü. Ek analjezi gereksinimi olduğunda 1 mg/kg dozunda intramüsküler petidin meperidin uygulandı. Bulgular: Litotripsi işlemi sırasında 5, 10, 15, 30 ve 40. Dakikalardaki ortalama VAS skorları grup I’deki hastalarda grup II’deki hastalara kıyasla anlamlı olarak daha düşüktü sırasıyla, P=0.011, P=0.009, P=0.001, P=0.000, P=0.000 . Ek analjezik gereksinimi, daha fazla şok dalgasına ve voltaja maruz kalan grup I’deki hastalarda grup II’dekilerden daha fazlaydı. Fakat bu fark istatistiksel olarak anlamlı değildi P=0.199 . Sonuç: Bu çalışma SWL işlemi sırasında IV parasetamol ile oral tramadolün analjezik etkinliğini karşılaştıran literatürdeki ilk araştırmadır. IV parasetamol, minimal yan etki ile oral tramadolden daha iyi analjezik etkinlik göstermektedir. Bununla birlikte daha fazla şok dalgası ve daha yüksek voltaj uygulanacak hastalarda az da olsa ek analjezik ihtiyacı olabileceği göz önünde bulundurulmalıdır

WOS: 000407103300011, With a widely usage of prostate specific antigen (PSA) testing as a screening tool, number of prostate biopsy procedures and number of biopsy cores are increased because of the negative pathology results. As a result of this condition, incidental pathological findings including the prostate and/or the seminal vesicles were encountered. Seminal vesicle amyloidosis is one of these incidental results. In this study we aimed to present a patient with amyloidosis of the seminal vesicles which was found on transrectal ultrasound guided prostatic biopsy.