The Predictive Value of the Systemic Immune-Inflammation Index for the Progression of Lower Urinary Tract Symptoms in Men.

INTRODUCTION: This retrospective cross-sectional observational study aimed to investigate the predictive value of the systemic immune-inflammation index (SII) for the progression of lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia (BPH). MATERIAL AND METHOD: A total of 280 patients diagnosed with LUTS were analyzed, and their demographic characteristics, laboratory results, urological parameters, and SII levels were recorded retrospectively. RESULTS: Clinical progression of LUTS was observed in 43.2% of the patients, with 23.9% undergoing surgery and 21.4% progressing to acute urinary retention. The study found that elevated SII levels were significantly correlated with disease progression and worse outcomes. Multivariate analysis revealed that peak urinary flow rate, erectile function scores, and platelet levels were risk factors for predicting clinical progression in LUTS/BPH patients. CONCLUSION: The findings suggest that systemic inflammation and immune dysregulation play a role in BPH pathogenesis and the development of LUTS. Incorporating SII assessment into routine clinical practice could aid in risk stratification, treatment decision-making, and monitoring of disease progression in LUTS/BPH patients.

Deep learning model-assisted detection of kidney stones on computed tomography

ABSTRACT Introduction: The aim of this study was to investigate the success of a deep learning model in detecting kidney stones in different planes according to stone size on unenhanced computed tomography (CT) images. Materials and Methods: This retrospective study included 455 patients who underwent CT scanning for kidney stones between January 2016 and January 2020; of them, 405 were diagnosed with kidney stones and 50 were not. Patients with renal stones of 0-1 cm, 1-2 cm, and >2 cm in size were classified into groups 1, 2, and 3, respectively. Two radiologists reviewed 2,959 CT images of 455 patients in three planes. Subsequently, these CT images were evaluated using a deep learning model. The accuracy rate, sensitivity, specificity, and positive and negative predictive values of the deep learning model were determined. Results: The training group accuracy rates of the deep learning model were 98.2%, 99.1%, and 97.3% in the axial plane; 99.1%, 98.2%, and 97.3% in the coronal plane; and 98.2%, 98.2%, and 98.2% in the sagittal plane, respectively. The testing group accuracy rates of the deep learning model were 78%, 68% and 70% in the axial plane; 63%, 72%, and 64% in the coronal plane; and 85%, 89%, and 93% in the sagittal plane, respectively. Conclusions: The use of deep learning algorithms for the detection of kidney stones is reliable and effective. Additionally, these algorithms can reduce the reporting time and cost of CT-dependent urolithiasis detection, leading to early diagnosis and management.

Deep learning model-assisted detection of kidney stones on computed tomography.

INTRODUCTION: The aim of this study was to investigate the success of a deep learning model in detecting kidney stones in different planes according to stone size on unenhanced computed tomography (CT) images. MATERIALS AND METHODS: This retrospective study included 455 patients who underwent CT scanning for kidney stones between January 2016 and January 2020; of them, 405 were diagnosed with kidney stones and 50 were not. Patients with renal stones of 0-1 cm, 1-2 cm, and >2 cm in size were classified into groups 1, 2, and 3, respectively. Two radiologists reviewed 2,959 CT images of 455 patients in three planes. Subsequently, these CT images were evaluated using a deep learning model. The accuracy rate, sensitivity, specificity, and positive and negative predictive values of the deep learning model were determined. RESULTS: The training group accuracy rates of the deep learning model were 98.2%, 99.1%, and 97.3% in the axial plane; 99.1%, 98.2%, and 97.3% in the coronal plane; and 98.2%, 98.2%, and 98.2% in the sagittal plane, respectively. The testing group accuracy rates of the deep learning model were 78%, 68% and 70% in the axial plane; 63%, 72%, and 64% in the coronal plane; and 85%, 89%, and 93% in the sagittal plane, respectively. CONCLUSIONS: The use of deep learning algorithms for the detection of kidney stones is reliable and effective. Additionally, these algorithms can reduce the reporting time and cost of CT-dependent urolithiasis detection, leading to early diagnosis and management.

The role of sperm DNA integrity in couples with recurrent implantation failure following IVF treatment.

There is increasing evidence from the literature that indicates the association between impaired sperm DNA integrity and male infertility. However, the data is insufficient regarding recurrent implantation failure (RIF) and sperm DNA damage. This study aimed to investigate the association between sperm DNA fragmentation and RIF cases. Basic semen parameters and sperm DNA fragmentation index (DFI) of men whose partner was suffering from RIF were compared with men whose partner was diagnosed with unexplained infertility (UEI) but had clinical pregnancies following IVF treatment. A retrospective analysis from a large-volume IVF center has been performed, and a total of 197 couples underwent analysis. Two groups were formed, couples with RIF and couples diagnosed with UEI but had clinical pregnancies (controls) following IVF cycles. The mean number of cycles showed significant differences between the groups. However, no statistical difference was observed between RIF and the control group regarding patient characteristics, semen parameters, and sperm DNA fragmentation index (DFI). Also, no statistically significant correlation was found between sperm DFI and clinical pregnancies in the unexplained infertility cohort. Our results show that sperm DNA fragmentation may not be an important contributing factor to RIF cases.

A novel prognostic risk factor for patients undergoing radical prostatectomy: Triglyseride-glucose index.

BACKGROUND: Obesity and metabolic syndrome are growing health problems in western countries. Recently reported triglyseride-glucose (TyG) index is a reliable and accessible indicator of metabolic syndrome. TyG index could be used as a indicator of a prognostic risk factor for metabolic syndrome-related cancers. OBJECTIVES: To investigate the prognostic role of TyG index on oncological outcomes in patients undergoing radical prostatectomy. DESIGN, SETTING AND PARTICIPANTS: Data from 200 men who underwent radical prostatectomy were used. OUTCOME MEASUREMENTS AND STATSITICAL ANALYSE: TyG was calculated based on TyG index = Ln [TG (mg/dL) FPG (mg/dL)/2] formula. Patients were divided into two groups according to the 8.55 level as cut-off value for TyG index. Laboratory results, oncological outcomes and survivals were comparised statistically between groups. RESULTS: Mean ages of patients were 64.32 ± 6.1 years and median follow-up time was 61.6 ± 35 (range 4-140) month. Biochemical recurrens was observed in 42 (21%) patients. Positive correlation between TyG index, body mass index, waist circumference, prostate biopsy gleason score, clinical T stage, positive surgical margin, pathological T stage and biochemical recurrence were observed. There was no statistical significance in terms of survival between groups. CONCLUSION: Association between TyG index and prostate cancer may facilitate to predict unfavorable prognostic factors of radical prostatectomy. Increased TyG index may use as a predictive marker of positive surgical margin status before radical prostatectomy, BCR, advanced cT and pT stages after radical prostatectomy or worse biopsy gleason score in clinical practice.

Novel predictive risk factor of erectile dysfunction: Serum 25-hydroxy vitamin D.

The present study aimed to investigate the association between the severity of erectile dysfunction (ED) and serum 25-hydroxy vitamin D. It also sought to determine the cut-off level of serum 25-hydroxy vitamin D for ED. This study included 130 men who had ED between 2018 and 2019. Patients were divided into three groups according to their scores on the international index of erectile function-5 (IIEF-5) Turkish validated short form questionnaire. The serum 25-hydroxy vitamin D results were compared between the groups. The mean age of the patients was 49.28 ± 13.62 years. Groups 1, 2 and 3 included 44 (33.8%) patients with severe ED, 56 (43.1%) patients with moderate ED and 30 (23.1%) patients with mild ED, respectively. Statistical significance was observed between the groups and serum 25-hydroxy vitamin D levels. A positive correlation was detected between the IIEF-5 scores, serum testosterone and serum 25-hydroxy vitamin D levels. A cut-off level for serum 25-hydroxy vitamin D was calculated as 27.32 ng/ml. During multivariate analysis, we found that serum 25-hydroxy vitamin D levels were independent prognostic risk factors for decreased IIEF-5 scores. Decreased serum 25-hydroxy vitamin D levels were associated with decreased IIEF-5 scores. Therefore, vitamin D replacement therapy may improve symptoms.

Systemic immune inflammation index is a promising non-invasive marker for the prognosis of the patients with localized renal cell carcinoma.

PURPOSE: Our aim was to evaluate the prognostic implications of a preoperative novel index, systemic immune inflammation index (SII) in patients undergoing surgery due to renal cell carcinoma. METHODS: A retrospective analysis of 176 patients who underwent radical nephrectomy and diagnosed with RCC was carried out. Systemic immune inflammation index, which is calculated by neutrophil x platelet/lymphocyte, and other inflammation indexes such as neutrophil/lymphocyte ratio, platelet/lymphocyte were included. The Kaplan-Meier analysis was plotted, and the groups were compared using a log-rank test. The ROC curve for the aforementioned inflammation indexes was plotted. RESULTS: SII (× 109/l) for lower and higher T stage group were 743.70 ± 587.55 and 907.06 ± 631.96, respectively, which is statistically significant (p = 0.01). Patients with higher Fuhrman grade (G3 and G4) were found to have higher SII (p = 0.001). SII 830 was demonstrated as the best cut-off value for overall survival. The optimal cut-off point for SII was defined as 850 for disease-specific survival. High SII scores were associated with poor overall survival in RCC patients (p = 0.034). However, no significant association was found for disease-specific survival (p = 0.29). CONCLUSIONS: Systemic immune inflammation index was found to be associated with increased TNM stage and poor prognosis of RCC patients udergoing radical nephrectomy.

Whortleberry protects kidney against the cisplatin-induced nephrotoxicity: an experimental study.

PURPOSE: This study investigated the antioxidant effects of whortleberry against cisplatin-induced nephrotoxicity in rats. MATERIAL AND METHODS: This study included 48 female Sprague-Dawley rats weighing 263.68 ± 8.29 g. The rats were divided into the following six groups, with eight rats in each group: control, ethanol control, whortleberry control, cisplatin control, 16 mg/kg cisplatin +100 mg/kg whortleberry, and 16 mg/kg cisplatin +200 mg/kg whortleberry groups. Biochemical analysis was performed by measuring total oxidant status and total antioxidant status, histopathological analysis was performed by calculating proximal and distal tubule areas (µm2), and immunohistochemical analysis was performed by determining anti-Caspase-3 immunostaining. Differences among the groups were examined using one-way analysis of variance, and p < .05 was considered statistically significant. RESULTS: Cisplatin treatment decreased the total antioxidant status and increased the total oxidant status and Caspase-3 level. Moreover, it resulted in the dilatation, vacuolization and loss of tubular epithelial cells; and glomerular degeneration and edema in the kidney tissues (p < .05). Treatment with 100 and 200 mg whortleberries increased the total antioxidant status; decreased the total oxidant status and Caspase-3 level and ameliorated distal and proximal tubule degeneration, glomerular degeneration and edema in the kidney tissues (p < .05). CONCLUSIONS: Our results indicate that the antioxidant effects of the whortleberry decrease cisplatin-associated nephrotoxicity.

The protective effect of astaxanthin against cisplatin-induced nephrotoxicity in rats.

PURPOSE: The aim of this experimental study was to investigate the antioxidant effects of astaxanthin against cisplatin-induced nephrotoxicity in rats. METHODS: Forty-eight male Sprague-Dawley rats weighing 264.83 ±â€¯7.39 g were randomly divided into six groups of eight animals each. These were constituted as control, olive oil control, astaxanthin control, cisplatin control, 16 mg/kg cisplatin & 25 mg/kg astaxanthin and 16 mg/kg cisplatin & 75 mg/kg astaxanthin groups. Biochemical evaluation was performed by measuring blood urea nitrogen, serum creatinine, total oxidant status and total antioxidant status. Renal corpuscle, proximal and distal tubules areas (µm2) were calculated for histopathological evaluation, and Caspase-3 staining was performed for immunohistochemical evaluation. RESULTS: Cisplatin reduced total antioxidant status levels and increased blood urea nitrogen, serum creatinine, total oxidant status, and Caspase-3 levels. It also caused dilatation, vacuolization, and loss of tubular epithelial cells in the proximal and distal tubules, and glomerular degeneration and edema were determined in kidney tissue (p < 0.05). Administration of 25 mg and 75 mg astaxanthin increased total antioxidant status levels, reduced blood urea nitrogen, serum creatinine, total oxidant status, and Caspase-3, and ameliorated degenerative distal and proximal tubules, glomerular degeneration and edema in kidney tissue (p < 0.05). CONCLUSIONS: The nephrotoxic effect of cisplatin was diminished by the antioxidant effect of astaxanthin.

WITHDRAWN: Comparison of vacuum-assisted closure therapy and debridement with primer surgical closure for fournier's gangrene treatment: 10 years' experience of a single centre.

The International Brazilian Journal of Urology will retract this article because the authors were not authorized to publish the data according to the Department of Urology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey, where the paper was done.

Association between Benign Prostatic Hyperplasia and Neutrophil-Lymphocyte Ratio, an Indicator of Inflammation and Metabolic Syndrome.

AIM: There is a large body of evidence of clinical studies regarding the relation between metabolic syndrome (MetS) and benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS) in men. A possible link between inflammation and these 2 clinical entities has also been proposed. Here, we aimed at evaluating the role of neutrophil-lymphocyte ratio (NLR), an indicator of inflammation and MetS, in the pathogenesis of LUTS and other BPH-related parameters. METHOD: We evaluated 244 patients with benign prostate hyperplasia admitted to our outpatient clinic between January 2014 and June 2015. NLR was calculated from the peripheral blood sample for all patients. Patients' anthropometric characteristics, serum lipid levels, waist circumferences, total prostate-specific antigen (PSA) and testosterone values, prostate volumes, max values and International Prostate Symptom Score (IPSS) were recorded. All statistical analyses were conducted by SPSS version 17.0 package program, and p value <0.05 was chosen as the criterion for statistical significance. RESULTS: There was statistical significance between NLR and patients with severe IPSS score (>20) and over age 60 years (p = 0.02). Patients younger than 60 years had statistical significance between NLR and PSA <2.5 ng/dl (p = 0.004). When body mass index was selected, there was statistical significance between prostate volume <35 ml (p = 0.009) and age >60 years (p = 0.028). If 60 years of age was selected as cut-off value, there is statistical significance between age and severe IPSS, and in terms of mild erectile dysfunction, PSA >2.5 ng/dl, and prostate volume >35 ml. CONCLUSION: We found positive correlation between NLR and severe symptoms and progression of BPH. In this manner, anti-inflammatory therapy could contribute to the medical treatment of BPH. Higher NLR may be a candidate marker for severity of symptoms in BPH patients.

Diabetes is an Important Risk Factor for Metastasis in Non- Muscle-Invasive Bladder Cancer.

BACKGROUND: Epidemiological evidence indicates that individuals with diabetes mellitus (DM) may have a modestly increased risk of bladder cancer. In the present study, we aimed to show any association between DM and risk of metastasis in patients with non-muscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS: We retrospectively analyzed 698 patients between January 2007 and December 2014 who were diagnosed with and underwent transurethral resection of bladder tumors (TUR-BT). Comparisons of means was conducted by independent samples t test, and relations between categorical variables were investigated by non-parametric chi- square test. A p value of 0.05 was accepted as statistically significant in comparisons. RESULTS: We analyzed 418 patients with non muscle invasive bladder cancer. 123 of whom were diabetic and 295 non-diabetic. In diabetic patients, 13 were N1 stage and 11 M1 stage. When compared with non diabetic patients that was statistically significant (p<0.001). TNM stages were more advanced in diabetic patients (p<0.001), but concurrent CIS (p=0.1) and squamous metaplasia did not significantly differ between diabetic and non-diabetic cases (p=1). CONCLUSIONS: Diabetic patients with non-muscle-invasive bladder cancer may suffer metastases earlier than expected although they are non invasive. Therefore such patients must be followed-up carefully and early cystectomy decision may be necessary. Further prospective studies with more patients are needed to confirm these findings.

Bladder injury secondary to obturator reflex is more common with plasmakinetic transurethral resection than monopolar transurethral resection of bladder cancer.

INTRODUCTION: Transurethral resection (TUR) is the most common surgical technique for the diagnosis and initial treatment of bladder cancer. In this study, we evaluated two surgical techniques in terms of bladder injury due to obturator reflex in patients that underwent TUR for non-muscle invasive bladder cancer (NMIBC). MATERIAL AND METHODS: 93 patients who underwent TUR for bladder cancer were analyzed. Fifty patients underwent monopolar resection and 43 patients underwent plasmakinetic resection. Standard TUR were performed with conventional Storz monopolar resection using a U-shaped cutting loop, 120V cutting/80 V coagulation settings, 5% mannitol fluid was used for irrigation. For bipolar resection, an Olympus ESG-400 plasmakinetic loop bipolar device using a U-shaped cutting loop, 160V cutting/80V coagulation settings and normal saline for irrigation was used. RESULTS: In the monopolar resection group; obturator reflex was seen in 4 (8%) patients. Bladder perforation caused by the obturator reflex was seen in 4 (8%) patients, but hemorrhage and other major complications were not seen in this group. In the bipolar resection group; obturator reflex was seen in 15 (34%) patients. Bladder perforation caused by the obturator reflex was seen in 10 (23%) patients. CONCLUSIONS: Bipolar transurethral resection of bladder tumor was not superior to monopolar resection with respect to obturator reflex and bladder perforation. We conclude that we do not yet have enough experience concerning the long-term complications and major complications associated with bipolar resection of bladder cancer.

Standardized uptake values highly correlate with tumor size and Fuhrman grade in patients with clear cell renal cell carcinoma.

BACKGROUND: We investigated the correlation between standardized uptake value (SUVmax), tumor size and Fuhrman grade in patients with renal cell carcinoma (RC). MATERIALS AND METHODS: We retrospectively analyzed the data of 54 patients with clear cell renal cell carcinoma histopathologically diagnosed who underwent fluorine-18 fluoro-2 deoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) between January 2005 and March 2014. RESULTS: Avarage tumor sizes were 5.64±1.85, 6.85±2.24 and 7.98±2.45 in low, medium and high SUVmax groups, respectively. The Spearman's correlation coefficient between the tumor size and SUVmax was 0.385 (p=0.004) and between the Fuhrman grade and SUVmax was 0.578 (p<0.001). CONCLUSIONS: SUVmax appears highly correlated with tumor size and Fuhrman grade in patients with histopathologically confirmed clear cell RC. Multicenter studies are needed to provide larger series for more accurate results.