ABSTRACT
SUMMARY OBJECTIVE: The aim of this study was to reveal the learning curve of early apical release en bloc laser prostatectomy using a high-power thulium (200 W) laser device. METHODS: We obtained data on the initial 60 patients who had thulium laser enucleation of the prostate by a single surgeon between October 2021 and August 2022 to treat the signs and symptoms of benign prostatic hyperplasia at our clinic. The cases were split into three groups, each consisting of 20 patients. Prostate volumes, prostate-specific antigen and hemoglobin levels, the International Prostate Symptom Score, Quality of Life scores, the International Index of Erectile Function-5 scores, and uroflowmetry parameters were documented preoperatively. The enucleation weight, the enucleation and morcellation times, as well as the efficiency, hospitalization, and catheterization durations were calculated. The patients were re-evaluated at 6 months postoperatively, examined for functional results, and compared to baseline conditions. RESULTS: Enucleation times, morcellation times, enucleation weight, and enucleation efficiency were significantly different among the groups. However, there was no statistically significant difference in total operative time and morcellation efficiency. In terms of postoperative statistics, the reduction in hemoglobin was significantly greater in Group 1 compared to Group 2. Six months after surgery, all groups had comparable validated ratings (International Prostate Symptom Score, Quality of Life, and the International Index of Erectile Function-5) on postoperative examinations. There were no long-term complications in either group throughout the perioperative period. CONCLUSION: Completing 40 first cases would be sufficient for managing the learning curve for early apical release en bloc thulium laser enucleation of the prostate.
ABSTRACT
SUMMARY OBJECTIVE: This study aimed to assess the quality of YouTube videos about microscopic varicocelectomy. METHODS: On November 20, 2022, a YouTube search for "Microscopic Varicocelectomy" was conducted. Non-English videos uploaded by producers for commercial purposes that lacked audio and subtitles were excluded from the study. A total of 50 videos were evaluated using the Journal of the American Medical Association Benchmark Score and the Global Quality Score, both of which are recognized internationally. Additionally, the researcher developed the Microscopic Varicocelectomy Score to evaluate the videos' technical content. The upload source, video length, number of views, likes, dislikes, and video power indexes were evaluated. RESULTS: The Global Quality Score, Journal of the American Medical Association Benchmark Score, and Microscopic Varicocelectomy Score of the academically prepared videos were significantly higher than those of the physician-prepared videos (p<0.05). The Global Quality Score, Journal of the American Medical Association Benchmark Score, and Microscopic Varicocelectomy Score of uploaded videos with audio, audio, and subtitles were significantly higher than those with only subtitles (p<0.05). The video duration was positively correlated with Journal of the American Medical Association Benchmark Score, Global Quality Score, and Microscopic Varicocelectomy Score. The video power index had a strong positive correlation with the number of likes. Moreover, a strong positive correlation was observed, indicating that the Global Quality Score and Journal of the American Medical Association Benchmark Score increased as the Microscopic Varicocelectomy Score increased. CONCLUSION: YouTube videos regarding microscopic varicocelectomy were of notably low quality. If the video content created by specialist physicians and academic centers is more meticulously organized, more accurate data can be transmitted. Consequently, viewing video content may not be advised based on the available data.
ABSTRACT
Aims: To investigate whether air in the kidney or bladder is only associated with gas-forming infection, or whether it can be observed after endoscopic interventions including ureteral and cystoscopic. If this is the case, what are the parameters that affect the amount of air in the urinary tract? Study Design: A prospective case series study. Place and Duration of Study: Sample: Department of Urology, Kafkas University Faculty of Medicine, between 2013 and 2014. Methodology: One hundred and forty patients who underwent any kind of ureteral intervention including flexible ureteroscopic lithotripsy (FURS-L), semi-rigid ureteroscopic lithotripsy (URS-L), double J stenting alone (JJS), URS-L + JJS, and FURS-L + JJS due to urinary system stones were enrolled. Computed tomography without contrast substance was performed 6 hours after ureteral intervention in order to determine whether there was any air in the urinary tract. Two groups were formed as group 1 and 2: less than 30 min and longer than 30 min of operation time. Results: Air in the kidney was observed in 40% (24/60) of the patients from group 1 and 80% (64/80) of the patients from group 2 (p<0.05). Air in the bladder was found in 53.3% (32/60) of patients in group 1 and 65% (52/80) in group 2 (p>0.05). The mean area of air (mm2) in the kidney for group 1 and group 2 was 6.54±5.56 and 13.59±15.1 (p>0.05). There were no significant relationships between side of the intervention, air in the kidney and bladder, operation time and waist circumference. Conclusion: Air-migration into the kidneys after ureteral insertions can occur, especially when the operation time is longer than 30 min. If fever or urosepsis is established after ureteroscopic interventions, this situation should be taken into account by the urologists before treating these patients for gas-forming infections.