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INTRODUCTION: We present a modification to the Bricker technique involving 124 anastomoses in a 62-patient series, and the outcomes of the procedures that have been carried out successfully to date in our clinic. METHODS: The study sample included patients who applied to our clinic for whom a radical cystectomy procedure was decided between 2012 and 2018. Among these patients, a retrospective evaluation was made of 62 patients on whom a diversion was performed using a modified Bricker technique during a radical cystectomy. RESULTS: The mean duration of follow-up was 15.9+-14 months, with a maximum of 59 months. There were 2 (3.2%) women among 62 patients. The preoperative stage was T3a in 5%, T2 in 56% and T1 high-grade in 39%. Among the 62 Bricker operations (124 anastomoses) carried out using the modified technique at our clinic, only one patient, who was stage T3b and who was being treated with postoperative adjuvant chemotherapy, developed left ureterohydronephrosis (0.8%). No stricture was observed in the other 123 anastomoses; and there were no late complications such as metabolic disturbance, stomal stenosis, pyelonephritis or lithiasis during the follow-up of the 62 patients who underwent a Bricker diversion. DISCUSSION AND CONCLUSION: We believe that the lack of anastomotic leakage in none of the operated patients and the occurrence of stricture in only one of 124 anastomoses in 62 patients is evidence of the success of the technique.

Endometrial cancer is the most common gynecological malignancy in women. Most patients are diagnosed in the early period because of irregular vaginal bleeding. The standard surgical procedures are total hysterectomy and bilateral salpingo-oophorectomy. Although it generally has a good prognosis, some patients may develop aggressive lymph node and distant organ metastases. In this case report, the right kidney and left adrenal gland metastases that occurred simultaneously during the follow-up of a patient who underwent total hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy for endometrial cancer will be described. There is no case reported in the literature regarding simultaneous kidney and adrenal metastasis of endometrial cancer.

Hematuria is a warning and serious symptom of the disease with a broad spectrum. Although it first brings to mind diseases related to benign pathologies at young ages, it is one of the clinical markers for cancer, especially in the elderly and requires further investigation. There are some risk factors for cancer-induced hematuria such as male gender, age >35, analgesic abuse, chronic hemodialysis, radiation exposure or carcinogens. Additionally, rare diseases should not be ignored in the differential diagnosis of hematuria. Here, we present an extremely rare case of renal rhabdomyosarcoma of kidney in an elderly female patient who was admitted to the emergency department with hematuria.

Objective: Testicular cancer (TCa) is still the most frequent solid organ cancer in men aged 15-35 years. Mean platelet volume (MPV) alteration is used as an indicator in some cancer. We evaluated MPV levels and their significance as one of the prognostic factors in TCa. Methods: Between January 2006 and October 2019, all TCa data of our clinic were researched. Total of 133 patients diagnosed with TCa enrolled. Age, tumor size, blood tests, clinicopathological data including lymphovascular invasion, pathological stage, invasion of epididymis, spermatic cord, surgical margin, retroperitoneal lymph node involvement in radiological examinations, and metastasis were recorded. The potential prognostic value of MPV was evaluated using receiver operating characteristics (ROC) curves. Prognostic factors were analyzed. Significant p was p

Introduction:The purpose of this study was to compare prostate-specific antigen (PSA), PSA density (PSAd), the prostate imaging-reporting and data system (PI-RADS) score, and lesion dimension (four parameters) in clinically significant prostate cancer (PCa) detection.Methods:This study included 154 patients who underwent multi-parametric prostate magnetic resonance imaging (mpMRI) and 12 quadrant systematic prostate biopsy between 01/2018 and 03/2019. Two radiologists used the PI-RADS version 2.1 to describe the MRI findings by consensus. A Gleason score ≥3+4 was assessed as clinically significant PCa. Areas under the curve (AUC) were calculated using receiver operating characteristics. Youden’s index was used to determine ideal cutoffs. DeLong’s test was used to evaluate statistically significant differences between the four parameters.Results:The median age was 66 (±6.9) in this cohort. The median PSA level was 7.8 ng/dL (±18.4, 1.6-109.3), the median PSAd was 0.146 ng/mL/cm3, and the median lesion dimension was 12 mm. In MRI, the number of cases with the PI-RADS scores from 1 to 5 were 34, 6, 11, 38, and 65, respectively. In terms of pathology, there was no tumor in 44 patients’ samples, while insignificant cancer and clinically significant PCa were seen in 33 and 77, respectively. The AUC values of PSA, PSAd, PI-RADS score, and lesion dimension were 0.684, 0.731, 0.856, and 0.858, respectively. The optimal cutoffs were ≥10 ng/mL for PSA, ≥0.22 ng/mL/cm3 for PSAd, ≥4 for the PI-RADS score and ≥10 mm for lesion dimension. DeLong’s tests showed that the PI-RADS score and lesion dimension were significantly superior to PSA and PSAd. There was no significant difference between the PI-RADS score and lesion dimension.Conclusion:The PI-RADS score and lesion dimension had higher accuracy than PSA and PSAd in clinically significant PCa detection. Lesions ≥10 mm were associated with the risk of clinically significant PCa, and this should be considered in reporting.

INTRODUCTION: We evaluated use of anticholinergics, mirabegron, and combination of anticholinergics with mirabegron during Bacillus Calmette-Guérin (BCG) instillation for reducing irritative symptoms in patients with non-muscle invasive bladder cancer (NMIBC). METHODS: Prospectively recorded data of NMIBC patients receiving BCG were retrospectively evaluated between August 2015 and April 2019. Patients with low-grade T1 solitary papillary lesions

Purpose: Imaging studies can show metastasis in testicular cancer (TCa); however, a test for risk of metastasis in TCa has not been described. The ratio of aspartate aminotransferase to alanine aminotransferase, also called the De Ritis ratio (DRR), is used for many other malignancies. We aimed to evaluate the association between preoperatively assessed DRR and prognosis in patients with TCa. Materials and Methods: One hundred twenty-eight patients with TCa were enrolled in a retrospective study between March 2007 and January 2017. Clinical, biochemical, and pathological data were recorded. Univariate and multivariate logistic regression analyses were used. The prognostic value of DRR and the threshold value were assessed by use of receiver operating characteristic curves. Significance was defined as p

Pelvic floor dysfunction is a clinical entity that is prevalent among female patients. Determining the exact underlying cause of pelvic floor dysfunction is difficult, and surgical intervention for this clinical entity may be challenging. Pelvic floor dysfunction can affect the quality of life of the patient by causing stress urinary incontinence, pelvic organ prolapse, or both. Well-defined surgical treatment options, minimally invasive approaches, and novel techniques for the treatment of pelvic floor dysfunction have been recently introduced. Here, we evaluated the management options available for patients with stress urinary incontinence and pelvic organ prolapse. We searched Medline and EMBASE databases for relevant articles by using the keywords “pelvic floor dysfunction,” “minimally invasive procedures,” “stress urinary incontinence,” “pelvic organ prolapse,” and “novel techniques”. Traditional treatment options for stress urinary incontinence and pelvic organ prolapse are beyond the scope of our review. Laparoscopic and robotic surgical treatments for pelvic floor dysfunction continue to evolve and develop. These minimally invasive techniques will soon replace open procedures. Alternative novel treatment modalities have also been developed from novel human-compatible materials and are emerging as successful treatments for stress urinary incontinence. The development of these various treatment options has implications for future surgical practice in the field of uro-gynecology.

Background: We aimed to study the continence between intermediate and high-risk cancer patients and the influential factors to recover continence. Materials and methods: In total, 655 patients underwent surgery by robot-assisted radical prostatectomy between 2010 and 2015. Of 655 patients, 294 were classified according to D'Amico risk groups as intermediate risk or high risk and completed the micturition protocol. Patients with intermediate risk were matched in a 1:1 ratio to patients with high risk for age and body mass index. Urine loss ratio (ULR) was defined as urine loss divided by micturition volumes. Immediate continence was defined with the best cut-off value of ULR. Results: In total, 117 patients with intermediate risk were matched to those with high risk. The comparison did not show any statistically significant difference in the ULR value (P = 0.359) or continence rate (P = 0.449). Predictive analysis was performed for the 294 patients (intermediate and high risk), of which 9.5% were classified as incontinent (>1 pad/d). Immediate continence was defined as ULR < 0.049 in 232 (78.9%) patients. Age, preoperative hemoglobin, and duration of catheterization were found influent by univariate analysis. Only age [odds ratio (OR) = 1.072; 95% confidence interval (CI) = 1.020–1.127; P = 0.006] and duration of catheterization (OR = 1.060; 95% CI = 1.003–1.120; P = 0.040) were independent influential factors to predict immediate continence. Conclusion: D'Amico intermediate- and high-risk groups do not differ in continence terms. The ULR value of < 0.049 identifies those patients who recover continence earlier. Age and duration of catheterization were influential factors in predicting immediate continence. Keywords: Predictive value of tests, Prostatectomy, Prostatic neoplasm, Urinary incontinence

Purpose: To investigate the effect on recurrence of vaporization of the tumor surroundings and suspicious areas with a plasma-kinetic (PK) system after transurethral resection (TUR) of nonmuscle invasive bladder cancer. Materials and Methods: The study included 121 patients with a primary superficial bladder tumor who were randomized as those who underwent TUR with the PK system (Group 1, n=62) and those who underwent TUR with the monopolar system (Group 2, n=59). The vaporization procedure was performed by suppressing the cutting option of the PK system for a period, which would accumulate energy sufficient to make swelling-waves on the mucosa very close to the area of the loop to be vaporized. Results: A total of 121 patients who met the study criteria were included for evaluation. Recurrence was determined in 21 patients in Group 1 (33.87%) and in 29 patients in Group 2 (49.15%) (p=0.088). Recurrence was close to the old resection site in 6 of 21 patients in Group 1, and in 13 patients in Group 2 (p=0.028); the difference was statistically significant. No statistically significant difference was determined between the two groups with respect to age, gender, number of tumor foci, rate or range of additional treatments applied, cigarette smoking rate, repeat TUR rate and rate of tumor en- countered in repeat TUR, T-stage, and tumor grade. Conclusions: The effect of vaporization on recurrence by the PK system may seem similar to the effect of standard TUR, the recurrence- lowering effect surrounding nonmuscle invasive bladder cancers is better.

Objectives: To provide a standardised report of complications after retroperitoneal laparoscopic radical nephrectomy (rLRN) in a high-volume centre using Clavien-Dindo classification. Materials and methods: We analysed records maintained in a prospective database of 330 consecutive patients that underwent rLRN between March 1995 and September 2016. All complications were graded according to the modified Clavien-Dindo classification. Three generations of surgeons were defined and the learning curve in rLRN was evaluated by comparing the first 100 cases (Group A) performed by firstgeneration surgeons with the last 100 cases (Group B) by thirdgeneration surgeons. Results: The mean age of our cohort was 66 ± 11.9 years. The overall complication rate was 19.7%. The majority of complications (12.7%) were Clavien 1 (5.1%) and Clavien 2 (7.6%) and did not require any interventions; blood transfusion was the most frequently encountered intervention (4.8%). Half of which were because of major intraoperative bleeding. Mortality rate was 0.9%. We found a trend towards lower complication rate in group B (19%) compared to group A (23%); this was mainly because of the reduction in the incidence of Clavien 1 and 2 complications. The pathological stage varied significantly in the two groups while the rate of negative surgical margins was comparable. Conclusions: rLRN is a safe procedure with an acceptable rate of complications. The learning curve was shorter for the thirdgeneration surgeons (group B); although these surgeons operated on a significantly higher number of patients with more advanced diseases. The Clavien-Dindo classification is suitable for assessing rLRN complications. Adopting this standardised system can help in the evaluation and comparison of surgical quality of LRN series.

Objective: To evaluate the effects of bladder neck reconstruction techniques on early continence after laparoscopic radical prostatectomy (LRP). Materials and methods: This non-randomized retrospective study analyzed prospectively collected data concerning LRP. In total, 3107 patients underwent LRP between March 1999 and December 2016. Exclusion criteria were preoperative urinary incontinence, previous history of external beam radiotherapy, co-morbities which may affect urinary continence such as diabetes mellitus and/or neurogenic disorders, irregular followup, and follow-up shorter than 24 months. All patients were divided into one of three groups, posterior reconstruction being performed in Group 1 (n = 112), anterior reconstruction in Group 2 (n = 762), and bladder neck sparing (BNS) in Group 3 (n = 987). Demographic and pre-, peri-, and postoperative data were collected. Multivariate analyses were performed to determine factors affecting early continence after LRP. Results: 1861 patients were enrolled in the study. The mean follow-up period was 48.12 ± 29.8 months, and subjects’ mean age was 63.6 ± 6.2 years. There was no significant difference among the groups in terms of demographic or preoperative data. Postoperative data, including oncological outcomes, were similar among the groups. The level of early continence was higher in Group 3 than in the other groups (p < 0.001). Multivariate analyses identified BNS and age as parameters significantly affecting early continence levels after LRP (p < 0.001 and p < 0.001, respectively). Bladder neck reconstruction provided less earlier continence than BNS.

Background&Aim: High grade non-muscle invasive bladder cancer (NMIBC) is common in urological practice. Most of these cancers are or become refractory to intravesical immunotherapy and chemotherapy. Here we evaluated the efficacy of combined local bladder hyperthermia and intravesical mitomycin-C (MMC) instillation in patients with high-risk recurrent NMIBC. Materials and methods: Between February 2014 and December 2015, 18 patients with high risk NMIBC were enrolled. Patients were treated in an outpatient basis with 6 weekly induction sessions followed by monthly maintenance sessions with intravesical MMC in local hyperthermia with bladder wall thermo-chemotherapy (BWT) system (PelvixTT system, Elmedical Ltd., Hod Hasharon, Israel). The follow-up regimen included cystoscopy after the induction cycle and thereafter with regular intervals. Time to disease recurrence was defined as time from the first intravesical treatment to endoscopic or histological documentation of a new bladder tumour. Adverse events were recorded according to CTC 4.0 (Common Toxicity Criteria) score system. Results: Mean age was 72 (32-87) years. 10 patients had multifocal disease, 9 had CIS, 6 had recurrent disease and 2 had highly recurrent disease (> 3 recurrences in a 24 months period). 6 patients underwent previous intravesical chemotherapy with MMC. The average number of maintenance sessions per patient was 7.6. After a mean follow-up of 433 days, 15 patients (83.3%) were recurrence-free. 3 patients had tumour recurrence after a mean period of 248 days without progression. Side effects were limited to grade 1 in 2 patients and grade 2 in 1 patient. Conclusions: BWT seems to be feasible and safe in high grade NMIBC. More studies are needed to identify the subgroup of patients who may benefit more from this treatment.

Urological anomalies can be seen in children with renal ectopia (RE) and can result in renal impairment. Therefore, we evaluated associated anomalies and renal outcome in our patients with RE. Sixty-eight children who were diagnosed with RE between January 2009–May 2014 were retrospectively studied. A total of 68 patients, 36 (52.9%) boys, with a median age of 67 months (4–201) and a median follow-up period of 14 months (3–113) were included in the study. Simple RE (S-RE) was found in 51 (75%) patients, of which 46 were unilateral and five were bilateral (discoid kidney). Crossed RE (C-RE) was detected in 17 (25%) patients. Voiding cystourethrogram was performed in 21/51 (41.2%) patients in S-RE group and 5/17 (29.4%) in C-RE group. We did not find vesicoureteral reflux (VUR) in any of the patients with C-RE, whereas, in S-RE group, VUR was demonstrated in six (6/21 - 28.6%) patients. Pelviureteric junction obstruction in ectopic kidney was found in two patients with S-RE and one with C-RE. Two patients (2/17 - 11.7%) had neurogenic bladder due to meningomyelocele, accompanied by imperforate anus in C-RE group. There were no significant differences in other associated urological anomalies between two groups. Renal impairment developed mostly in patients with additional urinary anomaly. The children with RE may have associated urinary anomalies, of which VUR is the most common. Complete urological investigation and regular follow-up are required in selected cases.

Objectives: To evaluate our clinical data on extraperitoneal laparoscopic radical prostatectomy (eLRP) with 3 trocars. Materials and Methods: All consecutive low-risk and intermediate/high risk without lymphadenopathy prostate cancer patients undergoing eLRP with using just 3 trocars by single surgeon (Y.A.) between 2017 and 2018 were included. Clinical data including patients' demographics, intraoperative and postoperative data, complications, and follow-up were recorded and analysed. We are presenting a video of one such case of eLRP with simultaneously right inguinal hernia repair (total extraperitoneal repair) with using 3 trocars. Surgeon (Y.A.) performed modified surgical technique (Heilbronn technique) (1) for eLRP with 3 trocars. Results: There were 36 cases in total with mean follow-up was 8 ± 0.4 months. Mean age was 69 ± 4.1 years old (Table 1). Mean prostate specific antigen was 8.7 ± 2.1 ng/dl (Table 2). Mean operating time was 117 ± 18 min. and 22 cases (10 bilateral and extrafascial) were performed nerve-sparing eLRP. Mean estimated blood loss was 170 ± 80 ml. Mean hospitalization day was 2.7 ± 1 days. Mean catheter removal day was 8 ± 3 days. Surgical margin was negative for all cases with 3 complications (Clavien 2) without major complications. Twenty-seven (75%) patients were continent and 20 (%55.5) patients had erections. Conclusions: The first advantage of this initial series is using just one assistant holding laparoscopic optic with/without hand-eye coordination. Second one is to have similar functional and oncology results with traditional eLRP in the literature with fewer trocars. Indirectly, more cosmesis is third one, as our approach seems more minimally invasive than traditional eLRP.eLRP with simultaneously hernia repair is feasible, safe, and effective with using just 3 trocars in selected cases.

ABSTRACT Objectives: To evaluate the long-term surgical, functional, and quality-of-life (QoL) outcomes after Holmium laser enucleation of the prostate (HoLEP) in patients with symptomatic benign prostatic hyperplasia (BPH). Materials and Methods: We retrospectively reviewed recorded data on patients who underwent HoLEP between June 2002 and February 2005. Ninety-six patients were enrolled. Demographic, perioperative, and postoperative data were recorded. On follow-up, International Prostate Symptom Scores (IPSSs), prostate-specific antigen (PSA) levels, QoL scores, peak uroflowmetric data (Qmax values), and post-voiding residual urine volumes (PVR volumes), were recorded. Complications were scored using the Clavien system. Statistical significance was set at p

Objectives: In the current study, we present our pure laparoscopic heminephrectomy experience in 13 patients with horseshoe kidney (HK). Material and Methods: A total of 13 patients with HK underwent pure laparoscopic heminephrectomy (Transperitoneal= 7, Retroperitoneal = 6) due to benign and malign renal conditions (non-functional hydronephrotic and/or infected kidney = 12, kidney mass = 1). Results: The mean age of the patients was 45.8 years. The mean operating time was 140 minutes, and estimated blood loss was 131 ml. The mean hospital stay was 2.3 days. Division of istmus was performed with stapler in 5 patients, ultrasonic scalpel in 3, 15 mm Hem-o-lok clip in 3, 10 mm LigaSure vessel seal system in one and endoscopic suture by 0 polyglactin in one patient without bleeding. Twelve patients underwent pure laparoscopic heminephrectomy due to nonfunctional hydronephrotic and or infected kidney. One patient underwent transperitoneal laparoscopic right heminephrectomy due to kidney mass. According to modifies Clavien classification, Grade I complication (wound infection) occurred in one patient (7.7%) who underwent heminephrectomy due to non-functional kidney. Conclusions: Laparoscopic heminephrectomy seems to be technically feasible and safe for benign and malignant diseases in patients with HK.

PURPOSEWe aimed to evaluate iatrogenic renal arterial lesions, including pseudoaneurysm, arteriovenous fistula, and arteriocaliceal fistula, their management by endovascular embolization, and the clinical results.METHODSFifty-five patients (forty males, fifteen females) with a median age of 40 years (range, 8–85 years), who underwent endovascular embolization of iatrogenic renal arterial lesions between March 2003 and December 2013 were included in this retrospective study. Types of iatrogenic lesions and details of embolization procedures were reported. Estimated glomerular filtration rate (eGFR), renal function tests, hemoglobin, and hematocrit levels before and after embolization were recorded and compared.RESULTSMedian follow-up was 24 months. We identified 53 pseudoaneurysms, 30 arteriovenous fistulas, and 11 arteriocaliceal fistulas in 55 patients, after percutaneous nephrolithotomy (n=26), renal biopsy (n=21), nephrostomy (n=3), renal surgery (n=3), and extracorporeal shock wave lithotripsy (n=2). Median number of pseudoaneurysms was 1 (range, 1–4) with a median size of 7 mm (range, 1.5–35 mm). Fifty-one patients underwent coil embolization. Median number of coils was 5 (range, 2–21) and median renal parenchymal loss was 5% (range, 1%–50%). There were no significant differences between pre- and postoperative eGFR and serum parameters.CONCLUSIONIatrogenic renal arterial lesion can be a life threatening condition. Superselective coil embolization is a safe, minimally invasive treatment option with minimal renal parenchymal loss and without significant change in renal function.

A 48-year-old man admitted to the urology outpatient clinic with major symptoms of right-side pain and intermittent lower urinary tract symptoms (LUTSs) such as low urine flow rate, dysuria, and frequency. Uroflowmetry showed low urine flow, and laboratory tests revealed no pathology. Ultrasound (US) showed a 7 cm calcific mass above the bladder and a kidney cyst with a diameter of 5.3 cm in the upper pole of the right kidney. Enhanced computed tomography confirmed the US findings. Laparoscopic transperitoneal renal cyst decortication was performed. There was no sign of additional tumors. An independent mass in the abdomen was diagnosed, and the mass was removed. Based on the pathology, the diagnosis was a benign mesenchymal calcific mass. This is the first report of LUTSs due to a free benign mesenchymal mass in the published literature.

When indications for laparoscopy were expanded to include a variety of urologic diseases, this increased the importance of prevention of complications, especially during the surgeons' learning curve period. Therefore, we evaluated the complications of urologic laparoscopic surgery in the course of one surgeon's experience including the learning curve after completing his long-term fellowship program. From December 2004 to August 2010, a total of 601 urologic laparoscopic surgical procedures were performed by a single surgeon who had finished a 9-month fellowship program at an experienced center. The intra- and postoperative complications of these cases were documented and graded according to the modified Clavien classification system, and then compared with the first and second 3-year periods. Of these 601 laparoscopic procedures, 47 complications occurred in 38 patients, resulting in a total complication rate of 7.8%. Conversion to open surgery occurred in four (0.6%) patients. Clavien grades I and II accounted for minor complications and occurred in 36 (5.9%) patients, whereas grades III, IV, and V accounted for major complications, which occurred in 11 (1.8%) patients. The annual complication rates formed a plateau in the 3rd year. Complication rates were significantly lower in the second 3-year period compared with the first 3 years (p

The iatrogenic ureter injuries are rare complications and may have serious consequences. The treatment options depend on situations. Pelvic surgeons, keep in mind that this kinds of complications, is very important for diagnosis and treatment, during the surgery. This report presents a case of a patient with iatrogenic left ureteral injury during hysterectomy. The patient visited emergency department of our hospital with the chief complaints of left lomber pain on the 17th day of hysterectomy. After evaluation in emergency clinic, the patient had an endoscopic treatment for iatrogenic ureter injury. The patient is still in follow-up period. We also review the literature and discuss diagnose, treatment, prognosis of iatrogenic ureter injuries. The treatmentoptions are still developing by technology.

Introduction: Urinary stone disease is a common urologic problem and recurrence in stone formation is a very familiar issue to urologists. Although recurrence in stone formation has been linked to metabolic abnormalities, it can be accessible by metabolic risk analysis studies.Methods: Herein, we present our experience in metabolic risk management on recurrence of urinary stones for 10 years in Akdeniz University School of Medicine department of Urology. We retrospectively analyzed Akdeniz University Urinary Stone Database between dates of January 2000 and December 2010. We found over 3500 patients who were managed by SWL (shock wave lithotripsy) or PCNL (percutaneus nephrolithotripsy) or URS (Ureterorenoscopic lithotripsy) or open surgery.Results: 525 patients’ metabolic risk analysis was ordered due to recurrent urinary stone disease. Only 134 (25.5 %) current metabolic analysis were returned. Mean patient age was 32.2 years (range: 19-82 years).Patients were 103 male and 31 female. Stone analysis results were CaOx monohydrate in 48 (35.8 %), CaOx dihydrate in 8 (5.9 %), CaOx mono and dihydrate in 70 (52.2 %), uric acid in 3, CaOx monohydrate and uricacid in 2, cystine in 2, and struvite in 1 patient, respectively. The metabolic risk analysis showed some abnormality in 54 (40.2 %) patients.Conclusion: Although compliance to metabolic risk analysis studies is low among recurrent urinary stone formers, some significant metabolic abnormalities could be detected in those who are effectively screened.Recurrence of urinary stones in patients who are started on appropriate metabolic management can be prevented.

Obezite tüm dünyada olduğu gibi ülkemizde de yükselen trendi ile büyük bir sağlık problemidir. Obezitenin günümüzde birçok hastalıkla ilişkisi belirlenmiştir. Bunlardan biride kadınlardaki stres üriner inkontinanstır. Obezite hem bu hastalığın nedenleri arasında, hem de inkontinansın şiddetini arttırabilen bir etken olarak rol oynamaktadır. Obezitenin stres inkontinanstaki rolü hakkın da halen araştırmalar devam etmektedir. Özellikle pelvik kaslarda ıkınma, gerilme, zayıflama yolu ile; sinirlerde de kronik irritasyonlara yol açarak etyolojide rol oynadığı bildirilmiştir. Yenileyin yapılan çalışmalarda obezitenin ve stres üriner inkontinansın ayrı ayrı ve birlikte hayat kalitesini azalttığına dair bilimsel yazılar literatürde yerini hızla almaktadır. Tedavi aşamasında ise öncelikle obezite ile mücadele, davranış modaliteleri ve gerektiğinde cerrahi tedavi gündeme gelebilir. Bu çalışmada kadınlarda obezite ve stres üriner inkontinans ilişkisinde güncel literatür eşliğinde bahsedilecektir.

Testicular neoplasm usually occur in men aged between 15 and 35. These are solid organ tumours and also should be operated when there is a suspicious clinical findings. Testis tumours are levelled after histopathology evaluation. The medical, surgical and follow-up strategies of well know testis tumours, such as seminomas, non-seminom germ cell tumours, have been established. In case of testis tumours rare entities may occur as rhabdomyosarcoma. We here presented a rare case of alveolar subtype of rhabdomyosarcoma in testis with long term follow-up.

Bilateral epididymal cysts are rare in childhood. Clinically they may present as acute scrotum and should be differentiated from other pathologies. Here in, we report bilateral epididymal cysts in a 14-year-old boy. He was admitted to emergency department with symptoms of acute left scrotum. There was no history of trauma or infection. Blood analyses, including testis tumor markers were unremarkable. Bilateral epididymal cysts were diagnosed on ultrasonography evaluation. Medical treatment did not stop his scrotal pain. During scrotal exploration, there was no evidence of testicular torsion or any other pathology. An excision of cyst was performed. Histopathologically, the cyst wall was lined by columnar epithelia. As a result of these findings, a pathological diagnosis of epididymal cyst was made. The synchronized evaluation of clinical and ultrasonography findings with an appropriate histopathological evaluation can usually diagnose this rare pathology.

Introduction: The aims of this study were fi rst, to determine whether peripheral levels of CD4+CD25highFoxp3+ regulatory T cells (Treg) are elevated in Prostate Cancer (PCa) patients, and second, to determine the direct correlation between peripheral Treg and total serum Prostate Specifi c Antigen (PSA) levels in these patients. Methods: Peripheral Blood Mononuclear Cells from 56 subjects undergoing diagnostic prostate biopsies (PSA ≥ 2.5 ng/ml) were analyzed for Treg numbers. The association between the peripheral Treg and serum PSA values was fi rst determined in the entire population, including people with no prostate pathology and PCa and Benign Prostate Hyperplasia (BPH) patients, and second, in nine PCa patients before and after curative prostatectomy. Results: This project was performed in Akdeniz University immunology laboratory and urology out patient clinic from 2008 to 2010. Peripheral Treg frequencies were signifi cantly increased in PCa patients (n = 19, 3.23 ± 1.59) compared with BPH patients (n = 27, 1.66 ± 0.80) and healthy subjects (n = 10, 1.08 ± 0.43) (p < 0.01). The percentage of Treg in BPH patients was also signifi cantly higher than that of healthy subjects (p < 0.01). Importantly, the increase in BPH and PCa patients paralleled the elevation in total serum PSA levels, demonstrating a strong positive correlation (r = 0.75; p < 0.01). Conclusion: These results demonstrate that peripheral Treg densities are correlated with PSA in BPH and PCa patients, suggesting that PSA may have a role in Treg induction and/or maintenance in Treg in these people.

ABSTRACT Objectives To investigate the impact of neck circumference (NC) in the treatment of bening prostatic hyperplasia (BPH) patients with metabolic syndrome (MtS). Additionally, we determined dose response to alpha-blockers and cut-off values for NC and waist circumference (WC), in these patients. Materials and Methods Non-randomized, open-labelled, and multi-centre study was conducted between March 2014 and September 2015. The BPH patients were enrolled and were divided into 2 groups: with MtS (Group 1; n=94) and without MtS (Group 2; n=103). Demographic data, anthropometric measurements, blood analyses, uroflowmetric parameters, post voiding residual urine (PVR), prostate volume, quality of life (QoL) index, NC and WC were recorded. Both groups were administered oral alpha-blockers and response to treatment was evaluated. Receiver-operating characteristic (ROC) curves were obtained and significant p was p

ABSTRACT Objectives: Apoptosis effect of oral alpha-blockers is known in the prostate. Apoptosis index of silodosin has not been proved, yet. Aims are to present apoptosis index of silodosin in prostate and to compare this with other currently used alpha-blocker's apoptosis indexes together with their clinical effects. Materials and Methods: Benign prostatic hyperplasia (BPH) patients were enrolled among those admitted to urology outpatient clinic between June 2014 and June 2015. Study groups were created according to randomly prescribed oral alpha-blocker drugs as silodosin 8mg (Group 1; n=24), tamsulosin 0.4mg (Group 2; n=30), alfuzosin 10mg (Group 3; n=25), doxazosin 8mg (Group 4; n=22), terazosin 5mg (Group 5; n=15). Pa- tients who refused to use any alpha-blocker drug were included into Group 6 as control group (n=16). We investigated apoptosis indexes of the drugs in prostatic tissues that were taken from patient's surgery (transurethral resection of prostate) and/or prostate biopsies. Immunochemical dyeing, light microscope, and Image Processing and Analy- sis in Java were used for evaluations. Statistical significant p was p