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Objective: To evaluate our initial experience in laparoscopic urological surgery.Materials and Methods: The results of patients who underwent laparoscopicsurgery between January 2015 and January 2018 were retrospectively evaluated.Results: Of the 88 patients, 50 (56.8%) were male and 38 (43.2%)were female. The mean age of the patients was 56 ± 14 (17-86) years. Surgicalprocedures were radical nephrectomy in 36 patients, simple nephrectomy in 26patients, partial nephrectomy in 3 patients, nephroureterectomy in 9 patients,dismembered pyeloplasty in 2 patients, adrenalectomy in 4 patients,ureterolithotomy in 7 patients, and orchiectomy in 1 patient. The mean operation time was 130±20,119±21, 140±5, 150±21, 117±3, 71±8, 80±11 and 45 minutes, respectively. Themean length of hospital stay was 4.2 ± 1.3, 3.1 ± 1.4, 4.3 ± 1.5, 4.7 ± 1.3, 4 ±1.4, 3 ± 0.8, 2.8 ± 1 and 1 days, respectively. Conversion to open surgery wasrequired in 13 (14.7%) patients including 4 patients underwent radicalnephrectomy, 6 patients underwent simple nephrectomy and 3 patients underwentnephroureterectomy. Postoperative complications were observed in 11 (12.5%) patients.Conclusion: Laparoscopic surgery, which is a minimal invasivesurgery, has a long learning curve but it can be performed successfully due tothe experience and ability of a surgeon with a suitable patient choice andcorrect planning at the beginning., Amaç: Laparoskopik ürolojik cerrahidekibaşlangıç deneyimlerimizi değerlendirmek. Gereç ve Yöntemler: Ocak 2015 ileOcak 2018 tarihleri arasında laparoskopik ürolojik cerrahi uygulanan hastalarınsonuçları retrospektif olarak değerlendirilmiştir.Bulgular: Kliniğimizde laparoskopik cerrahi yapılan88 hastanın 50’ si (%56.8) erkek, 38’ i (%43.2) kadındı. Hastaların ortalamayaşı 56 ± 14 (17-86) yıl idi. Otuz altı hastaya radikal nefrektomi, 26 hastayabasit nefrektomi, 3 hastaya parsiyel nefrektomi, 9 hastaya nefroüreterektomi, 2hastaya dismembered pyeloplasti, 4 hastaya adrenalektomi, 7 hastayaüreterolitotomi, 1 hastaya ise orşiektomi uygulandı. Ortalama operasyon süresisırasıyla 130±20, 119±21, 140±5, 150±21, 117±3, 71±8, 80±11 ve 45 dk, ortalamahastanede kalış süreleri sırasıyla 4.2±1.3, 3.1±1.4, 4.3±1.5, 4.7±1.3, 4±1.4,3±0.8, 2.8±1 ve 1 gündü. Radikal nefrektomi yapılan hastaların 4’ ünde, basitnefrektomi yapılan hastaların 6’ sında ve nefroüreterektomi yapılan hastaların3’ ünde olmak üzere toplam 13 (%14,7) hastada açık cerrahiye geçildi.Postoperatif komplikasyon 11 (%12,5) hastada görüldü.Sonuç: Laparoskopik cerrahi; öğrenme eğrisi uzun olan, cerrahın yeteneğine vetecrübesine bağlı olarak çok iyi fonksiyonel sonuçlar veren minimal invazivcerrahi yöntemlerden birisi olarak başlangıç döneminde uygun hasta seçimi vedoğru planlama ile başarılı bir şekilde uygulanabilmektedir.

Conclusion: We found high numbers of fluoroquinolone-resistant E. coli in faeces collected prior to prostate biopsy. Thus, fluoroquinolones should not be used for prostate biopsy prophylaxis. We found no difference in the extent of quinolone-resistance in patients graded by age, prostate specific antigen level, or antibiotic use in the prior 6 months. In risky cases, faecal culture results may be used to choose appropriate prophylaxis.

Conclusions. Age, nocturnal polyuria, metabolic syndrome and sleep disturbances have been shown to be contributing factors in the frequency of nocturia and LUTS. Therefore, steps taken to alleviate factors that can be altered - such as hypertension, weight gain, sleep disturbances and IPSS - may improve the individual's quality of life

Conclusion: Antibiotic resistance has been estimated to be higher in our region compared to similar studies. Regional antibiotic resistance patterns are important in empirical treatment. It is important to investigate antibiotic resistance patterns periodically in our region.

A patient presented with a mass in the cavernous body. The mass, 1 cm in diameter, was detected in the left cavernous body on the MRI and color Doppler ultrasound of the penis of the patient, who presented with pain approximately 3 months after a blunt trauma to the pelvic region. According to the statement of the patient, any direct trauma to the penis was obscure. The lesion was resected and pathological examination of the removed mass revealed pseudoaneurysm. J Androl 2012;33:585-587

The frequency of complications subject to stents has increased as a natural result that ureteral stent indications increase and its usage becomes widespread gradually. There has been renal insufficiency, sepsis and death cases reported developing due to stents forgotten in patients with solitary kidneys in literature. Patients with solitary kidneys cannot give sufficient care to their stents instead of clinic precautions. In this case report, we present acute renal failure findings developed subject to double J stent forgotten for four years in a patient right non-functional kidney. We should be more careful due to catastrophic results created by stent forgotten in patients with single functional kidney. Telling stent indications, period and complications in details to patients to whom ureteral stent will be placed might provide them become more interested., Üreteral stentlerin endikasyonlarının artması ve kullanımının giderek yaygınlaşmasının doğal sonucu olarak stentlere bağlı komplikasyonların görülme sıklığı da artmıştır. Literatürde soliter böbrekli hastalarda unutulmuş stentlere bağlı gelişen böbrek yetmezliği, sepsis ve ölüm vakaları rapor edilmiştir. Soliter böbrekli hastalar klinik önemlerine rağmen stentlerine yeterli ilgiyi göstermemektedir. Bu olgu sunumunda sağ nonfonksiyone böbrekli hastada dört yıl süre ile unutulan double J stente bağlı gelişen akut böbrek yetmezliği tablosu sunulmuştur. Fonksiyonel tek böbreği olan hastalarda unutulmuş stentin oluşturabileceği katastrofik sonuçlar nedeniyle daha dikkatli olunmalıdır. Üreteral stent takılması planlanan hastalara stent endikasyonları, süresi ve komplikasyonlarının ayrıntılı anlatılması hastanın daha ilgili olmasını sağlayabilir

Nadiren görülen ‘burned-out’ testis tümörü, herhangi bir tedavi olmaksızın histolojik gerileme ve primer testis tümörü lezyonun kaybolması ile karakterize germ hücreli tümör olarak tanımlanır. Fizik muayenede hiçbir kanıt olmaması tanı koyulmasını zorlaştırır. Tanı için radyolojik görüntüleme yöntemlerinin önemi artmaktadır. Otuzbir yaşındaki erkek hasta, sağ testiste sertlik nedeniyle hastanemize başvurdu. Fizik muayenede sol testis normal iken, sağ testisin üst kutbunda şüpheli bir nodül vardı. Skrotal manyetik rezonansta sağ testiste 14 * 11 mm boyutlu kitle tespit edildi. İnguinal orşiektomi yapıldı ve patolojik tanı “ tam regresyon gösteren germ hücreli tümör “ olarak rapor edildi. Non-metastatik ‘burned-out’ testis tümör literatürde sınırlı sayıda bildirilmiştir ve bu tümörün tanısı metastaz olmadığında karmaşık olabilmektedir. ‘Burnedout’ testis tümörü olgularında, hem tedavi hem tanın doğrulanması için cerrahi biran önce yapılmalıdır, A rarely seen ‘burned-out’ testis tumor is defined as the germ cell tumor, characterized by histologic regression and disappearance of the primary testicular tumor lesion without any treatment. Absence of any specific evidence of physical examination makes the diagnosis difficult, and increases the importance of radiological imaging works. A 31-year-old male patient applied to our hospital because of a hardness in the right testis. On the physical examination, there was a suspicious nodule at the upper pole of the right testis whereas the left testicle was normal. A mass was detected in scrotal magnetic resonance with the size of 14 * 11 mm in the right testis. Inguinal orchiectomy was performed and the final pathological diagnosis was concluded as “germ cell tumor showing total regression”. Non-metastatic burned-out testicular tumors are limited in number reported in the literature and their diagnoses might be sometimes complicated. In burned -out testicular tumor cases, surgery should be carried out immediately to confirm the diagnosis and for the treatment

Amaç: Çalışmamızda benign prostat hiperplazisi cerrahi tedavisinde, monopolar transuretral rezeksiyon prostatektomi TUR-P ile bipolar TUR-P’nin postoperatif erken dönem klinik sonuçlarını karşılaştırmayı amaçladık.Gereç ve Yöntemler: Kliniğimizde Eylül 2011 ile Mayıs 2012 tarihler arasında monopolar TUR-P grup M ve bipolar TUR-P grup B planlanan, her birinde 40’ar hasta bulunan iki med as M and B respectively, each containing ayrı grup oluşturuldu. Çalışmaya prostat ağırlıconsecutive 40 patients. The patients with patğı en az 30 gr olan hastalar dahil edildi, prostat ağırlığı için üst sınır kriteri kullanılmadı. Patoloji sonucu prostat kanseri çıkan hastalar çalışma dışı bırakıldı. Her iki grubun operasyon öncesi hemoglobin, hematokrit, serum Na, K, Cl düzeyleri ve operasyon sonrası ilk 2. saat ve 24. saatte ölçülen hemoglobin, hematokrit, serum Na, K, Cl düzeyleri karşılaştırıldı. Gruplar ayrıca hastanede kalma, üretral kateterizasyon ve operasyon süreleri yönünden de karşılaştırıldı.Bulgular: Her iki grupta postoperatif serum Na, K, Cl, hemoglobin ve hematokrit değerlerinde preoperatif değerlere oranla düşme olduğu saptandı. Gruplar arası karşılaştırmada serum Na, K, Cl oranlarında istatistiksel anlamlı fark saptanmadı p>0.05 . Grup B’de grup M’ye göre hemoglobin ve hematokrit düzeylerinin daha az düştüğü tespit edildi, ancak aradaki fark istatistiksel olarak anlamsızdı p>0.05 . Grup B’de grup M ile karşılaştırıldığında üretral kataterizasyon 2,4 / 2,2 gün , operasyon 47 /50 dk ve hastanede kalma sürelerinin 3,9 / 3,6 gün olduğu, aralarında istatistiksel fark olmadığı görüldü. Tüm değişkenler açısından farklılıklar p> 0,05 istatistiksel anlamlı bulunmadı.Sonuç: Sistemler arasında hemoglobin, hemotokrit ve serum elektrolit düzeylerine etki yönünden fark yoktur. Bipolar TUR-P ve Monopolar TUR-P sistemlerinin elimizdeki verilere göre erken postoperatif dönemde etkileri benzerdir, Objectives: The aim of this study was to compare the early clinical results of monopolar transurethral resection prostatectomy TUR-P with bipolar TUR-P in the surgical treatment of BPH. Materials and Methods: Between September 2011- May 2012 we performed monopolar and bipolar TUR-P in two different groups named as M and B respectively, each containing consecutive 40 patients. The patients with pathologic diagnosis of prostate cancer were excluded from the study. Preoperative and postoperative 2 hours and 24 hours data regarding complete blood count and serum levels of Na, K, Cl values were compared to each other. Both groups were also compared in respect to hospital stay, duration of operation and urethral catheterization. Results: Postoperative values of hemoglobin, hematocrit and serum Na, K, Cl of two groups decreased significantly p0,05 . Mean duration of urethral catheterization, operation and hospital stay in group M were 2,4 days, 50 minutes and 3,9 days versus in group B 2,2 days, 47 minutes and 3,6 days respectively. The differences in respect to all variables were not significant p>0,05 . Conclusion: Bipolar TUR-P in the levels of serum electrolytes between the two methods were similar. Based on the available data, in postoperative early period of bipolar TUR-P is similar to monopolar TUR-P

Amaç: Çalışmamızda, üriner sistem enfeksiyonu etkeni olan bakteriyel mikroorganizmaların çeşitliliği ve hastanemizdeki güncel antibiyotik duyarlılığının belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışmada Ocak 2012- Aralık 2012 tarihleri arasında Sakarya Eğitim Araştırma Hastanesi üroloji polikliniğine başvuran hastalardan istenen 3244 idrar kültüründe üremesi olan 403 olgu retrospektif olarak incelendi. Kültür örneklerindeki üremesi kontaminasyon kabul edilen veya 18 yaşından küçük olan hastalar çalışmaya alınmadı. Bulgular: Çalışmaya alınan olguların yaş ortalaması 49 idi. Olguların %58’i erkek, %42’si kadın hastalardı. İdrar kültürlerinden 403 mikroorganizma soyutlandı. Kültürlerin 366’sında gram negatif, 37’sinde gram pozitif etken izole edildi. En sık izole edilen bakteri %77,6 oranında Escherichia coli idi. Örnekle rin antibiyotik duyarlılıkları incelendiğinde %40,1’i ampisilin-subaktama, %36,5’i siprofloksasine, %31,4’ü trimetropimsulfametaksazole, %20,3’ü sefuroksim aksetile, %16,2’si seftriaksona, %13,9’u gentamisine dirençli bulundu.Sonuç: Üriner sistem enfeksiyonlarının tedavisinde uygunsuz ilaç kullanımından dolayı son zamanlarda temel antibiyotiklere karşı direnç gelişiminde dramatik artış görülmektedir. Ampirik tedavilerde bölgesel direnç paterninin bilinmesi önemlidir. Hastanemizdeki güncel direnç paterninin belirlenmesi ampirik tedavi yaklaşımımızı değiştirmiştir, Objective: In this study we aimed to evaluate the bacterial diversity of causative agent of urinary tract infection and current antibiotic susceptibility in our hospital.Materials and Methods: In this study we evaluated 403 patients whose 3244 urine culture with microbial growth that applied Sakarya Education and Research hospital between January and December 2012. The patients that reproduction of culture in samples accepted contamination and under the age of 18 excluded from the study.Results: The mean age was 49. 58% of patients were male, 42% were female. 403 microorganisms reproducted in the cultures. In 366 cultures gram negative microroganism and in 37 cultures gram positive microorganisms ısolated. The most frequently isolated agent is E.coli bacterium with 77.6%. When the antibiotic susceptibility of the samples analyzed, 40.1% were found resistant to ampicillin-sulbactam, 36.5% ciprofloxacin, 31.4% trimethroprim-sulfamethoxazole, 20.3% cefuroxime, 16.2% ceftriaxone and 13.9% were found resistant to gentamicin. Conclusion: Due to inappropriate medication in the treatment of urinary tract infections, resistance to antibiotics recently dramatic increases in basic seen. For empirical therapy it is important to know the regional patterns of resistance. Periodic monitoring of resistance patterns in our hospital has changed our approach to empirical therapy

Introduction: The objective of this study was to investigate the disease course after direct vision internal urethrotomy (DVIU) for short anterior urethral strictures. Methods: We retrospectively analyzed 94 patients who underwent DVIU of the anterior urethra. Patients' age, etiology, length and localization of the strictures, total number of DVIU procedures, comorbidities, and other data were evaluated. Results: The mean age of the patients was 67.2 years. The mean followup duration was 27.1 months. Recurrence was observed in 27.6% of the patients. Recurrence had occurred in these patients at a mean of 12 months. Both the comorbidity score (rs=0.395; p

Objective Recent studies have demonstrated the role of systemic inflammation in the development and progression of cancer. In this study, we evaluated whether preoperatively measured neutrophil-to-lymphocyte ratio (NLR) can predict lamina propria invasion in patients with non-muscle-invasive bladder cancer (NMIBC). Material and Methods We reviewed the medical records of 304 consecutive and newly diagnosed patients with bladder cancer who had been treated with transurethral resection between January 2008 and June 2014. In total, 271 patients were included in the study and the patients were divided into two groups according to the pathological stage (Group 1: Ta, Group 2: T1). NLR was calculated by dividing the absolute neutrophil count (N) by the absolute lymphocyte count (L). Results In total, 271 patients (27 women and 244 men) were enrolled. Mean age was higher in Group 2 than in Group 1 (67.3±10.8 vs. 62.9±10.8, p

Introduction. Women suffer from depression more frequently than men, which indicates that sex hormones might be involved in the etiology of this disease. Aims. The purpose of this study was to assess the relationship between testosterone and depression pathophysiology in depressive women along with sexual function. We also investigated whether antidepressant treatment causes any change in levels of this hormone or in sexual function. Methods. Premenopausal female patients aged 25-46 years (n = 52) with diagnosed major depression were included in this study as the patient group, and 25- to 46-year-old premenopausal women without depression (n = 30) were included as the control group. Main Outcome Measures. Serum testosterone and sex hormone-binding globulin (SHBG) levels were measured twice, before and after the antidepressant treatment. Bioavailable testosterone (cBT) levels were calculated using the assay results for total testosterone (TT), SHBG, and albumin according to the formulas of Vermeulen et al. Depression severity was measured using the 17-item Hamilton Depression Rating Scale, and sexual function was evaluated with the Arizona Sexual Experience Scale. Results. The mean TT and cBT levels significantly increased in the patient group after the antidepressant treatment (P < 0.001). Pre-treatment TT and cBT levels were significantly lower in the patient group than in the control group (P < 0.001). Similar results were obtained for post-treatment serum TT and cBT levels in the patient and control groups (P > 0.05). There were no significant differences among the groups in terms of SHBG level. Conclusion. The low testosterone levels in depressed women compared with women in the control group and the elevated levels post-pharmacotherapy suggest that testosterone may be involved in depression.

Purpose.In this retrospective study, we aimed to investigate the effects of androgen deprivation therapy (ADT) on blood glucose and blood cholesterol levels over a 12-month period.Materials and Methods.Between January 2010 and June 2012, the data of 44 patients with prostate cancer who were receiving ADT were collected from a hospital database. Patients with additional malignancy or diabetes and those who had been prescribed and were currently taking cholesterol-lowering medication were excluded from the study. Data (including fasting blood glucose levels and a cholesterol profile) were collected and analysed statistically. A value Results.Twelve months after the initiation of ADT, fasting blood glucose (FBG), total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglyceride (TG) levels changed. FBG, TC, LDL cholesterol, and TG increased significantly (, 0.000, 0.000, and 0.000, resp.), while HDL cholesterol decreased ().Conclusion.ADT may increase FBG, TC, LDL cholesterol, and TG but decrease HDL cholesterol by the end of a year of treatment. Therefore, close followup may be needed as a consequence of one-year ADT regarding metabolic alterations.

Background/aim: Studies suggest that trace elements may have an adverse impact on male reproduction, even at low levels. We tried to investigate the relationships between these metals and semen quality in various body fluids among men with infertility. Materials and methods: A total of 255 samples of blood, semen, and urine were collected from 85 men suffering from infertility. Inductively coupled plasma-optical emission spectrometry was used for the determination of 22 trace elements. We compared the results of the semen parameters with the results of the element determinations. Results: Because of the high proportion of samples with values lower than the limit of detection for a number of the elements, only 8 of a total 22 trace elements were determined in the samples. When the concentrations of sperm were classified according to the World Health Organization?s guidelines for normospermia, oligospermia, and azoospermia, statistically significant differences were found among Zn, Ca, Al, Cu, Mg, Se, and Sr concentrations in various serum, sperm, and urine samples (P < 0.05). Conclusion: In the present study, we found significant correlations between concentrations of Zn, Ca, Al, Cu, Mg, Se, and Sr and semen parameters in various body fluids.

A 78 year old man was admitted to our urology polyclinic with painless penile mass. The lesion was 3,5 cm in size on the ventral aspect of the penis. He had been using a pad for urinary incontinance for ten months but he said he had the lesion increasing in size for past 3 months. He underwent a wide local excision under local anesthesia. The histopathologic diagnosis was fibroepithelial polyp. A fibroepithelial polyp of the penis is very rare and strongly linked to long-term condom catheter use. We present a case of fibroepithelial polyp of the glans which is not associated with condom catheter use.

A 46-year old man was admitted with a scrotal long standing painless mass. The work up included physical examination, alpha- fetoprotein (αFP) and beta-human chorionic gonadotropin (β-hCG) analyses, scrotal ultrasound (US), magnetic resonance imaging (MRI) and urethrocystoscopy. The patient underwent surgery. Surgical exploration revealed a separate mass between the testes extending superiorly with a thin stalk. It was dissected easily to the anterior aspect of the seminal vesicles and removed from the junction to the seminal vesicles. Pathology reported an epidermoid cyst. To our knowledge this is the first case of a scrotal extratesticular epidermoid cyst attached to the seminal vesicles. Epidermoid cysts can be seen anywhere in the midline from the cranium to the anus. Embriologically abnormal closure of neural groove or epithelial fusion lines is one of the theories that seem more probable. Genital epidermoid cysts are rare, painless and usually located in the testes. Up to date less than 10 case reports of extratesticular epidermoid cysts have been published. For those cases malignancy may not be ruled out, so the surgical removal was advocated.

This study aimed to examine the effect of postoperative addition of a local anesthetic agent to irrigation fluid on the alleviation or prevention of pain after transurethral resection of the prostate (TURP).This prospective, double blind, placebo-controlled study included 50 patients aged 50 to 87 years. The patients were randomized into two groups. As each patient began to experience postoperative pain after spinal anesthesia wore off, 30 mL of 2% prilocaine was injected into the irrigation solution bags, and the bladder was irrigated (prilocaine group). The irrigation solution used in the control group was prilocaine-free. Visual analog scale (VAS) scoring was used to assess the severity of pain. Bladder irrigation in all patients was discontinued 1 day postsurgery.There was not a statistical difference in surgical parameters between the two groups. All patients in the prilocaine group were satisfied with the analgesic efficacy of prilocaine, except for two (8%). The mean number of irrigation solution bags (3000 mL) used for each patient in the prilocaine group was 7.04 ± 1.2. Prilocaine-related side effects were not observed. Conversely, pain developed in all but two patients in the control group. The mean number of irrigation solution bags used for each patient in the control group was 7.6 ± 1.8. Mean VAS pain score was 0.35 ± 0.12 and 5.10 ± 3.26 in the prilocaine and control groups, respectively (P0.001).Prilocaine solution safely alleviated postoperative pain in the patients who underwent TURP. The use of continuous bladder irrigation with a diluted prilocaine solution consistently decreased the need for parenteral analgesics.