One-year Follow-up Results of Transperineal Biopsy For Patients Undergoing Irreversible Electroporation Treatment in Localized Prostate Cancer.

OBJECTIVE: This article reports on the early results of a 1-year follow-up study investigating the efficacy of irreversible electroporation in the treatment of localized prostate cancer. METHODS: The study included 18 out of 40 patients diagnosed with low- and intermediate-risk prostate cancer who underwent irreversible electroporation. Treatment results were evaluated through confirmation biopsies, comparing prostate-specific antigen levels, international prostate symptom scoring, and international index of erectile dysfunction scores before irreversible electroporation and at the 12-month mark. RESULTS: The mean age of the patients was 61.1 years (SD ±6.5). Out of the 18 patients, 16 were tumor free (88.8%), while 2 experienced recurrences, one within the treatment field and the other outside of it (P < .001). Irreversible electroporation significantly reduced mean prostate-specific antigen levels (6.73 ng/mL vs. 2.05 ng/mL, P < .001), indicating a 69.5% reduction within 12 months. Furthermore, there was a significant improvement in mean international prostate symptom scores at the 12-month followup (10.05 vs. 7.52, P=.003). The mean international index of erectile dysfunction scores before treatment was 19.17 (SD ±5.85), and after irreversible electroporation, it was 18.67 (SD ±6.34), with no statistically significant change (P=.065). CONCLUSION: The short-term oncological results of irreversible electroporation treatment are promising, particularly for patients in the low- and intermediate-risk groups. Additionally, irreversible electroporation does not negatively impact the international index of erectile dysfunction; however, it may lead to a decrease in international prostate symptom scores.

Evaluation of clinical and mpMRI findings of irreversible electroporation therapy for the treatment of localized prostate cancer: Preliminary results.

OBJECTIVE: To evaluate early clinical and multiparametric prostate magnetic resonance imaging (mpMRI) results of irreversible electroporation (IRE) efficiency in treatment of localized prostate cancer. MATERIAL AND METHODS: For the patients in whom IRE was performed for local ablation, mpMRI was used for the sixth month follow-up. These images were compared with the mpMRI images obtained before the procedure. We performed transperineal fusion biopsy to patients with diagnosis of localized prostate cancer. We treated the eligible ones with IRE. Six of them have completed their 6-month follow-up period. We compared preoperative prostate specific antigen (PSA), international prostate symptom score, international index of erectile function (IIEF), and mpMRI of these patients with those obtained at the sixth month of follow-up. Side effects experienced by the patients were evaluated as well. RESULTS: We had 10 patients who received IRE treatment. Six patients completed their sixth month-follow-up and came for control visits. At the end of 6 months, the mean decrease in PSA level was 73%. IIEF results were seen not to have changed significantly. On mpMRI, diffusion restriction was seen to have disappeared except for one patient, and Prostate Imaging Reporting Data System scores were decreased. CONCLUSION: We concluded that early clinical and mpMRI results for IRE in the focal ablative treatment of localized prostate cancer were gratifying. As an ambulatory procedure with a low incidence of side effects, we look forward to seeing the long-term results of IRE treatment.

Does the experience of the bedside assistant effect the results of robotic surgeons in the learning curve of robot assisted radical prostatectomy?

ABSTRACT Introduction: The success of the robot assisted radical prostatectomy (RARP) procedures depend on a successful team, however the literature focuses on the performance of a console surgeon. The aim of this study was to evaluate surgical outcomes of the surgeons during the learning curve in relation to the bedside assistant's experience level during RARP. Materials and Methods: We retrospectively reviewed two non - laparoscopic, beginner robotic surgeon's cases, and we divided the patients into two groups. The first surgeon completed the operations on 20 patients with a beginner bedside assistant in February - May 2009 (Group-1). The second surgeon completed operations on 16 patients with an experienced (at least 150 cases) bedside assistant in February 2015 - December 2015 (Group-2). The collected data included age, prostate volume, prostate specific antigen (PSA), estimated blood loss, complications and percent of positive surgical margins. In addition, the elapsed time for trocar insertion, robot docking, console surgery, specimen extraction and total anesthesia time were measured separately. Results: There were no significant differences between the groups in terms of age, comorbidity, prostate volume, PSA value, preoperative Gleason score, number of positive cores, postoperative Gleason score, pathological grade, protection rate of neurovascular bundles, surgical margin positivity, postoperative complications, length of hospital stay, or estimated blood loss. The robot docking, trocar placement, console surgery, anesthesia and specimen extraction times were significantly shorter in group 2 than they were in group 1 (17.75 ± 3.53 min vs. 30.20 ± 7.54 min, p ≤ 0.001; 9.63 ± 2.71 min vs. 14.40 ± 4.52 min, p = 0.001; 189.06 ± 27.70 min vs. 244.95 ± 80.58 min, p = 0.01; 230.94 ± 30.83 min vs. 306.75 ± 87.96 min, p = 0.002; 10.19 ± 2.54 min vs. 17.55 ± 8.79 min, p = 0.002; respectively). Conclusion: Although the bedside assistant's experience in RARP does not appear to influence the robotic surgeon's oncological outcomes during the learning curve, it may reduce the potential complications by shortening the total operation time.

Does the experience of the bedside assistant effect the results of robotic surgeons in the learning curve of robot assisted radical prostatectomy?

INTRODUCTION: The success of the robot assisted radical prostatectomy (RARP) procedures depend on a successful team, however the literature focuses on the performance of a console surgeon. The aim of this study was to evaluate surgical outcomes of the surgeons during the learning curve in relation to the bedside assistant's experience level during RARP. MATERIALS AND METHODS: We retrospectively reviewed two non - laparoscopic, beginner robotic surgeon's cases, and we divided the patients into two groups. The first surgeon completed the operations on 20 patients with a beginner bedside assistant in February - May 2009 (Group-1). The second surgeon completed operations on 16 patients with an experienced (at least 150 cases) bedside assistant in February 2015 - December 2015 (Group-2). The collected data included age, prostate volume, prostate specific antigen (PSA), estimated blood loss, complications and percent of positive surgical margins. In addition, the elapsed time for trocar insertion, robot docking, console surgery, specimen extraction and total anesthesia time were measured separately. RESULTS: There were no significant differences between the groups in terms of age, co-morbidity, prostate volume, PSA value, preoperative Gleason score, number of positive cores, postoperative Gleason score, pathological grade, protection rate of neurovascular bundles, surgical margin positivity, postoperative complications, length of hospital stay, or estimated blood loss. The robot docking, trocar placement, console surgery, anesthesia and specimen extraction times were significantly shorter in group 2 than they were in group 1 (17.75 ± 3.53 min vs. 30.20 ± 7.54 min, p ≤ 0.001; 9.63 ± 2.71 min vs. 14.40 ± 4.52 min , p = 0.001; 189.06 ± 27.70 min vs. 244.95 ± 80.58 min, p = 0.01; 230.94 ± 30.83 min vs. 306.75 ± 87.96 min, p = 0.002; 10.19 ± 2.54 min vs. 17.55 ± 8.79 min, p = 0.002; respectively). CONCLUSION: Although the bedside assistant's experience in RARP does not appear to influence the robotic surgeon's oncological outcomes during the learning curve, it may reduce the potential complications by shortening the total operation time.

Risk Factors of Infectious Complications after Flexible Uretero-renoscopy with Laser Lithotripsy.

PURPOSE: To determine the perioperative risk factors for postoperative infections among patients undergoing flexible uretero-renoscopy with laser lithotripsy (FURSLL). In addition, the resistance patterns of pathogens isolated from positive preoperative urine cultures were investigated. MATERIALS AND METHODS: We retrospectively reviewed data from 492 consecutive patients who had undergone FURSLL for stone disease in our department. Postoperative infection was defined as fever (? 38°C) with pyuria (? 10 white blood cells per high power field), or systemic inflammatory response syndrome, or sepsis. Pre-operative and intra-operative characteristics between patients with and without postoperative infectious complications were compared using univariate analyses. Significant variables on univariate analyses were included in a multivariatelogistic regression analysis to evaluate risk factors associated with postoperative infection following FURSLL. RESULTS: 42 (8.5%) of 492 patients had postoperative infectious complications after FURSLL. 59 (12%) of 492 patients had a positive preoperative urine culture. 19 (32.2% of 59) patients had multidrug resistance (MDR) isolates recovered from positive preoperative urine cultures. 75% (9/12 cultures) of the positive preoperative urine cultures of patients in whom a postoperative infectious complication developed consisted of gram-negative pathogens. On multivariate analysis positive preoperative MDR urine culture (OR:4.75;95%CI:1.55-14.56; P = .006) was found to be significant with the dependent variable as the postoperative infectious complications despite appropriate preoperative antibiotic therapy. CONCLUSION: We found that positive preoperative MDR urine culture is a significant risk factor for infectious complications after FURSLL. Our findings point to the need for further research on assessment of risk factors forMDR infections to reduce the rate of postoperative infectious complications.

The relationship between histological prostatitis and lower urinary tract symptoms and sexual function.

This prospective analysis assessed the effect of histological prostatitis on lower urinary tract functions and sexual function. The patients were separated into two groups as histologically observed prostatitis (Group A) and no prostatitis (Group B) according to the biopsy outcomes. International prostate symptom score, international index of erectile function-5 scores, maximal and average flow rate, and residual urine volumes were compared statistically between groups. There was no significant difference (P>0.05) in baseline age (t=0.64), body mass index value (t=0.51), prostate volume (t=0.87), prostate-specific antigen levels (t=0.43), maximal (t=0.84) and average flow rate (t=0.59), and post-void residual urine volume (t=0.71). Mean international prostate symptom score in patients with prostatitis was numerically but not significantly higher than that in those without prostatitis (t=0.794, P=0.066). Mean international index of erectile function-5 score in the prostatitis group was significantly lower than that in those without prostatitis (t=1.854, P=0.013). Histological prostatitis notably affected sexual function of patients and may serve as a major risk factor for sexual dysfunction while having little effect on lower urinary tract symptoms.

The relationship between histological prostatitis and lower urinary tract symptoms and sexual function

ABSTRACT This prospective analysis assessed the effect of histological prostatitis on lower urinary tract functions and sexual function. The patients were separated into two groups as histologically observed prostatitis (Group A) and no prostatitis (Group B) according to the biopsy outcomes. International prostate symptom score, international index of erectile function-5 scores, maximal and average flow rate, and residual urine volumes were compared statistically between groups. There was no significant difference (P>0.05) in baseline age (t=0.64), body mass index value (t=0.51), prostate volume (t=0.87), prostate-specific antigen levels (t=0.43), maximal (t=0.84) and average flow rate (t=0.59), and post-void residual urine volume (t=0.71). Mean international prostate symptom score in patients with prostatitis was numerically but not significantly higher than that in those without prostatitis (t=0.794, P=0.066). Mean international index of erectile function-5 score in the prostatitis group was significantly lower than that in those without prostatitis (t=1.854, P=0.013). Histological prostatitis notably affected sexual function of patients and may serve as a major risk factor for sexual dysfunction while having little effect on lower urinary tract symptoms.

Value of preoperative stone scoring systems in predicting the results of percutaneous nephrolithotomy.

INTRODUCTION: Guy's Stone Score and S.T.O.N.E. Nephrolithometry nomograms have been introduced for systematic and quantitative assessment of kidney stones. The aim of this study was to reveal the value of two scorings systems, Guy and S.T.O.N.E, most frequently used for predicting postoperative stone-free status prior to Percutaneous Nephrolithotomy (PCNL), in the prediction of postoperative results of PCNL. MATERIAL AND METHODS: We retrospectively examined patients who underwent PCNL. Preoperative abdominopelvic computerized tomography images of these patients were reviewed and scored according to the Guy and S.T.O.N.E. systems. The relationship between the Guy and S.T.O.N.E. scores, and their postoperative stone-free status, complications based on Clavien system, operation time, fluoroscopy time and period of hospitalization was compared. RESULTS: We identified a total of 102 patients who underwent PCNL between 2010 and 2014, having met the inclusion criteria. The relationships between the total S.T.O.N.E score and Clavien score (p <0.001); time of operation (p = 0.012) and stone-free status (p <0.001); Guy stone score and Clavien score (p <0.001); and period of hospitalization (p <0.001) and time of operation (p <0.001) were found to be statistically significant. There was no statistically significant relationship between Guy score and stone-free status and no statistically significant relationship was found between fluoroscopy time and both stone scoring systems. CONCLUSIONS: Guy and S.T.O.N.E. scoring systems may be used as effective instruments particularly for predicting postoperative complications.

Comparison of one-year results of transobturator tape method in the stress incontinence treatment according to body mass index.

OBJECTIVE: The purpose of this study was to compare the 1-year results of patients on whom we used the transobturator tape method for the stress incontinence treatment according to body mass index (BMI). MATERIAL AND METHODS: Patients diagnosed with stress incontinence and treated with the transobturator tape method were divided into three groups according to BMI. We recorded the results of preoperative urodynamic studies; durations of operation, catheterization, and hospitalization; and complications of patients. Patients were evaluated 1 year after the operation with respect to the objective/subjective success rates of the operation, patient satisfaction rates, and possible late complications. RESULTS: The obese group was observed to have a significantly higher duration of operation than the normal and overweight groups (p<0.001). The objective and subjective success rates were not significantly different between the groups (p=0.567 and p=0.245, respectively). There was no statistical difference between the groups with respect to the satisfaction rates (p=0.245). There was no significant difference between all three groups with respect to both preoperative and postoperative complication rates (p=0.096). CONCLUSION: The transobturator tape method for stress incontinence treatment has similar objective and subjective success rates, independent of BMI. In the obese patients, the operation time is longer than the others, but there is no difference with respect to the complication rates.

Laparoscopic simple nephrectomy patient with situs inversus totalis and left renal hypoplasia: A case report.

Situs inversus totalis (SIT) is a relatively rare anatomical condition characterized by the transposition of thoracic and abdominal organs from the normal side to the opposite position. Most reports of laparoscopic procedures in patients with SIT cite technical difficulties and longer operative times due to disorientation because of the reversed abdominal organs and necessary modification of the surgeon's movements and techniques. We present a case of a patient with SIT in whom a transperitoneal laparoscopic simple nephrectomy was performed.

Trace elements levels in the serum, urine, and semen of patients with infertility.

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.

Relationship between development of urethral stricture after transurethral resection of prostate and glycemic control.

OBJECTIVES: The purpose of this study is to investigate the association of glycemic control prior to TUR-P and postoperative urethral stricture development. MATERIALS AND METHODS: Of the 168 patients with a diagnosis of urethral stricture, who underwent internal urethrotomy in our hospital were retrospectively analyzed for this study. 98 patients who underwent monopolar TUR-P in our hospital previously and were developed urethral stricture were divided into two groups as diabetic and nondiabetic. Based on their HbA1c concentrations, diabetics were allocated to two groups with good (HbA1c ≤6.5%) or poor (HbA1c > 6,5%) glycemic control. Time to internal urethrotomy and the other operative parameters were compared among groups. RESULTS: Time to internal urethrotomy after TUR-P was significantly shorter in diabetic patients with poor glycemic control than Group 1 and Group 2 (P = 0,02, P = 0,012) but no significant difference was found between Group 1 and Group 2 (P = 0,368). There was no significant difference in the mean diagnosed and resected prostate wight among groups There was no significant difference in the mean resection time and the mean time to urethral catheter removal among groups. CONCLUSIONS: Especially in poor glycemic control patients, urethral stricture development was seen in the early period after TUR-P. For this reason, in the elective TUR-P scheduled poor glycemic controlled patients the operation should be done after glycemic control.

Early results of a novel technique for anterior vaginal wall prolapse repair: anterior vaginal wall darn.

BACKGROUND: The aim of this study was to describe the results of a 1-year patient follow-up after anterior vaginal wall darn, a novel technique for the repair of anterior vaginal wall prolapse. METHODS: Fifty-five patients with anterior vaginal wall prolapse underwent anterior vaginal wall darn. The anterior vaginal wall was detached using sharp and blunt dissection via an incision beginning 1 cm proximal to the external meatus and extending to the vaginal apex. The space between the tissues that attach the lateral vaginal walls to the arcus tendineus fasciae pelvis was then darned. Cough Stress Test, Pelvic Organ Prolapse Quantification, seven-item Incontinence Impact Questionnaire, and six-item Urogenital Distress Inventory scores were performed 1-year postoperatively to evaluate recovery. RESULTS: One-year postoperatively, all patients were satisfied with the results of the procedure. No patient had vaginal mucosal erosion or any other complication. CONCLUSIONS: One-year postoperative findings for patients in this series indicate that patients with stage II-III anterior vaginal wall prolapse were successfully treated with the anterior vaginal wall darn technique.

Experiences with the management of paraurethral cysts in adult women.

INTRODUCTION: Paraurethral cysts may be acquired or congenital pathology, and are rarely encountered in urogynecologic practice. Therefore, no consensus on management of paraurethral cyst could be reached. We aimed to report our experience on the management of paraurethral cysts in adult women. MATERIAL AND METHODS: A retrospective chart review was conducted on adult women diagnosed with paraurethral cysts between 2011 and 2012. Patients' complaints, parity, physical signs, diagnostic tests and the obtained findings, surgical intervention, duration of follow-up period, complications, recurrence and histologic examination of the cysts wall were evaluated in the patients included. RESULTS: Ten adult women, aged 23-48 years (mean: 41 years) with paraurethral cysts between 2011 and 2012 were identified. All patients were multiparous. The patients' complaints included palpable mass, dyspareunia, and dysuria. All patients underwent preoperative urethrocystoscopy. All the cysts were solitary and in dimension of 1 to 3.5 cm and localized in the distal urethra. All patients underwent surgical excision. The mean follow-up period was 8 months (range: 6-12 months). Neither complications nor recurrences were observed. Histopathological examination showed that 5 cysts were lined with squamous epithelium, 2 were lined with transitional epithelium, and 3 were lined with both types of epithelium. CONCLUSIONS: Paraurethral cysts may be symptomatic and routine urological examinations are sufficient for diagnosis without using advanced imaging technique. In such symptomatic adult patients, partial surgical resection combined with fulguration can be performed effectively without complications. This treatment modality seems exceptional according to the literature.

Efficacy of surgical techniques and factors affecting residual stone rate in the treatment of kidney stones.

OBJECTIVE: In this study, we aimed to evaluate, the efficacy of surgical methods and the factors affecting the residual stone rate by scrutinizing retrospectively the patients who had undergone renal stone surgery. MATERIAL AND METHODS: Records of 109 cases of kidney stones who had been surgically treated between January 2010, and July 2013 were reviewed. Patients were divided into three groups in terms of surgical treatment; open stone surgery, percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS). Patients' history, physical examination, biochemical and radiological images and operative and postoperative data were recorded. RESULTS: The patients had undergone PNL (n=74; 67.9%), RIRS (n=22;20.2%), and open renal surgery (n=13; 11.9%). The mean and median ages of the patients were 46±9, 41 (21-75) and, 42 (23-67) years, respectively. The mean stone burden was 2.6±0.7 cm(2) in the PNL, 1.4±0.1 cm(2) in the RIRS, and 3.1±0.9 cm(2) in the open surgery groups. The mean operative times were 126±24 min in the PNL group, 72±12 min in the RIRS group and 82±22 min in the open surgery group. The duration of hospitalisation was 3.1±0.2 days, 1.2±0.3 days and 3.4±1.1 days respectively. While the RIRS group did not need blood transfusion, in the PNL group blood transfusions were given in the PNL (n=18), and open surgery (n=2) groups. Residual stones were detected in the PNL (n=22), open surgery (n=2), and RIRS (n=5) groups. CONCLUSION: PNL and RIRS have been seen as safe and effective methods in our self application too. However, it should not be forgotten that as a basical method, open surgery may be needed in cases of necessity.

Testosterone levels and sexual function disorders in depressive female patients: effects of antidepressant treatment.

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.

Intestinal perforation after radical cystectomy due to drain: case report.

The current standard treatment for nonmetastatic invasive bladder cancer is radical cystectomy with urinary diversion. Radical cystectomy surgery carries a serious potential risk of complications. In this case report, an intestinal perforation which was thought to be occurred due to a Foley catheter placed as a drain after the cystectomy is presented.

The effects of age, metabolic syndrome, nocturnal polyuria and sleep disorders on nocturia.

BACKGROUND: Nocturia, which is especially frequent among older men, adversely affects the individual's quality of life. It is regarded as one of the most bothersome lower urinary tract symptoms (LUTS). OBJECTIVES: The aim of the study was to investigate factors contributing to the frequency of nocturia. MATERIAL AND METHODS: Men ≥ 40 years with LUTS were enrolled in this study. After medical histories were taken and physical examinations conducted, biochemical tests and measures for LUTS were carried out. Anthropometric measurements were performed and Epworth scores (ES) were examined. Patients were divided into two groups with respect to nocturia: the first group having no nocturia or one incident of nocturia per night, and the second group with two or more nightly incidents of nocturia. The data were analyzed statistically; p < 0.05 was considered significant. RESULTS: A total of 118 consecutive patients (56 ± 10 years) were enrolled in the study. The first group consisted of 31 participants, while the second group contained 87 patients. The groups differed significantly with respect to age, body height, body weight, waist circumference and body mass index (BMI). ES, prostatic volumes, maximum flow rates (Qmax) and international prostate symptom scores (IPSS) were significantly different. Fasting blood glucose levels were similar for both groups. Homeostasis model assessment (HOMA) scores showed borderline significance. Insulin levels were different, while insulin resistance (IR) was similar between the groups. Nocturnal polyuria was associated with nocturia, systolic blood pressure and IPSS. 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.

Do the values of prostate specific antigen obtained from fresh and dried urine reflect the serum measurements?

AIM: To investigate if free PSA (fPSA) and total PSA (tPSA) values obtained from simultaneously collected urine, fresh and dried on filter paper, reflect the serum free and total PSA. MATERIALS AND METHODS: The sera and 20 cc first voided urine from 33 consecutive men aged between 40 and 84 (mean 61 ± 12), were collected in the morning and delivered to the laboratory. Three different aliquots of 100 microgram urine were taken with automatic pipette and dropped on 3 certain areas of a filter paper and allowed to dry for each patient. On each paper, borders of dried urine were marked. PSA values were obtained from the sera and fresh urine samples and recorded. Later on particular days dried urine samples were dissolved and eventually PSA values were derived and recorded again. The results were compared to each other. Correlations were evaluated by using an SPSS statistics program. RESULTS: Serum PSA values correlated weakly (r < 0.24) with fresh and dried urine PSA values. While PSA in fresh and dried urine samples showed strong correlation (0.5 < r < 0.74), a very strong correlation (r > 0.75) among PSA values of dried urine samples of 1-day, 7- and 28-days, were seen. CONCLUSIONS: We conclude that PSA values obtained from fresh and dried urine could not reflect serum PSA values. But, because dried urine on a filter paper can be stable for years, it could be used for forensic purposes.

A unique scrotal extratesticular epidermod cyst attached to the seminal vesicles.

A 46-year-old man was admitted with a scrotal long standing painless mass. The workup included physical examination, alpha-fetoprotein (αFP) and beta-human chorionic gonadotropin (ß-hCG) analyses, scrotal ultrasound, magnetic resonance imaging and urethrocystoscopy. 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.