Factors affecting the need for ureteral catheterization in symptomatic pregnancy hydronephrosis.

PURPOSE: In our study, considering the clinical parameters we aimed to determine the most appropriate treatment approach for symptomatic gestational hydronephrosis and conditions requiring DJS insertion. METHODS: Our study was a retrospective cross-sectional study and 137 patients were included. The patients were divided into two groups: those with conservative follow-up and those with DJS. Demographic and clinical data, the degree of HUN detected in urinary ultrasonography and the anteroposterior diameter of the renal pelvis were evaluated. Factors affecting the need for DJS between groups were investigated. Also, it was aimed to determine the cut-off value for the HUN degree and renal pelvis AP diameter in patients with DJS. RESULTS: The presence of urinary system stones was statistically significantly higher in the group with DJS than in the group without DJS (p = 0.014). HUN degrees and AP diameter were statistically significantly higher in the DJS group (p < 0.001, p < 0.001, respectively). HUN degree and renal pelvis AP diameter were the two most important predictors for DJS insertion (p = 0.005, p = 0.015, respectively). The AP diameter cut-off value for DJS installation was determined as 20.5 mm. CONCLUSION: Although there are conservative and surgical treatment options for symptomatic hydronephrosis of pregnancy, the factors at the decision point between these options are still a matter of debate. In our study, we concluded that the most important determinants at this decision point are the HUN degree and renal pelvis AP diameter. We think that the cut-off values we have determined for these markers will guide clinicians in deciding on treatment.

Impact of Preoperative Video-Based Education on Anxiety Levels in Patients with Renal Stones Scheduled for Flexible Ureteroscopic Lithotripsy: A Comparative Study Using APAIS and STAI.

BACKGROUND Anxiety prior to surgery can impact patient outcomes and satisfaction. In light of this, our study aimed to examine the effects of preoperative video-based information versus verbal information on anxiety levels among 60 patients with renal stones slated for flexible ureteroscopic lithotripsy. Anxiety was measured using the Amsterdam Pre-Operative Anxiety and Information Scale (APAIS) and the State-Trait Anxiety Inventory (STAI). MATERIAL AND METHODS We enrolled 60 patients with renal stones who were scheduled for flexible ureteroscopic lithotripsy. These patients were divided randomly into two groups: Group 1 (30 patients) received preoperative video-based information and Group 2 (30 patients) received only verbal information. Anxiety levels were assessed preoperatively using both the APAIS and STAI. On the first postoperative day, each patient indicated their pain using a visual analogue scale and filled out a questionnaire about their willingness to undergo the procedure again. RESULTS Group 1 exhibited lower anxiety levels as reflected by the APAIS scores for anesthesia (P=0.02), surgery (P<0.001), overall (P<0.001), and information needs (P<0.001). While there was no significant difference in the STAI-trait anxiety scores between the groups (P=0.15), Group 2 demonstrated notably higher anxiety levels concerning the surgical procedure, as measured by the STAI-state scores (P<0.001). The average pain score was 4.23 ± 2.17 for Group 1 and 5.37 ± 2.83 for Group 2 (P=0.08). Patients in Group 1 showed a greater willingness to undergo the surgery again (P=0.02). CONCLUSIONS Delivering preoperative information through videos significantly diminishes anxiety levels in patients about to undergo retrograde intrarenal surgery compared to traditional verbal communication.

The effect of screen time on the presentation and treatment of primary monosymptomatic nocturnal enuresis.

BACKGROUND: We aimed to investigate if there was any relationship between screen time (ST) and the severity of primary monosymptomatic nocturnal enuresis (PMNE) and treatment success. METHODS: This study was conducted in urology and child and adolescent phsychiatry clinic in Afyonkarahisar Health Sciences University Hospital. After diagnosis patients were seperated by the ST for exploring causation. Group 1 > 120, Group 2 < 120 (min/day). For the the treatment response, patients were grouped again. Group 3 patients were administered 120 mcg Desmopressin Melt (DeM) and were requested < 60 min ST. Patients in Group 4 were given 120 mcg DeM solely. RESULTS: The first stage of the study included 71 patients. The ages of the patients ranged from 6 to 13. Group 1 comprised 47 patients, 26 males and 21 females. Group 2 comprised 24 patients,11 males and 13 famales. Median age was 7 years in both groups. The groups were similar in respect of age and gender (p = 0.670, p = 0.449, respectively). A significant relationship was determined between ST and PMNE severity. Severe symptoms were seen at the rate of 42.6% in the Group 1, and at 16.7% in the Group 2 (p = 0.033). 44 patients completed the second stage of the study. Group 3 comprised 21 patients, 11 males and 10 females. Group 4 comprised 23 patients,11 males and 12 famales. Median age was 7 years in both groups. The groups were similar in respect of age and gender (p = 0.708, p = 0.765, respectively). Response to treatment was determined as full response in 70% (14/20) in Group 3 and in 31% (5/16) in Group 4 (p = 0.021). Failure was determined in 5% (1/21) in Group 3 and in 30% (7/23) in Group 4 (p = 0.048). Recurrence was determined at a lower rate in Group 3 where ST was restricted (7% vs. 60%, p = 0.037). CONCLUSION: High screen exposure may be a factor for PMNE aetiology. And also reducing ST to a normal range can be an easy and beneficial method for treatment of PMNE. Trial Registration ISRCTN15760867( www.isrctn.com ). Date of registration: 23/05/2022. This trial was registered retrospectively.

Effect of Re-TUR time on recurrence and progression in high-risk non-muscle-invasive bladder cancer.

OBJECTIVE: We aimed to investigate the significance of time to re-staging transurethral resection (re-TUR) on recurrence and progression rates in patients with high-risk non-muscle-invasive bladder cancer as a prospective randomized study. METHODS: The patients were randomly separated into three groups according to Re-TUR timing. In Groups 1, 2, and 3, the time interval between initial and re-TUR was 14-28 days, 29-42 days, and 43-56 days, respectively. Cox regression analysis was used to assess the effect of time from initial TUR to re-TUR on oncological outcomes. RESULTS: Twenty patients in Group 1 (14-28 days), 22 patients in Group 2 (29-42 days), and 29 patients in Group 3 (43-56 days) completed the study. Kaplan-Meier plots showed no differences in recurrence-free survival (RFS) and progression-free survival (PFS) rates between the three groups. Cox regression analysis demonstrated that only tumor number was found to be a prognostic factor on RFS rates. CONCLUSION: Our prospective study demonstrated that time laps from initial TUR to re-TUR did not significantly affect on RFS and PFS rates.

OBJETIVO: Nuestro objetivo fue investigar la importancia del tiempo para volver a estadificar la resección transuretral (re-RTU) en las tasas de recurrencia y progresión en pacientes con cáncer de vejiga no músculo invasivo de alto riesgo como un estudio prospectivo aleatorizado. MÉTODO: Los pacientes se separaron aleatoriamente en 3 grupos de acuerdo con el tiempo de Re-TUR. En el grupo 1, 2 y 3, el intervalo de tiempo entre la RTU inicial y la nueva fue de 14 a 28 días, 29 a 42 días y 43 a 56 días, respectivamente. Cox para evaluar el efecto del tiempo desde la RTU inicial hasta la nueva RTU sobre los resultados oncológicos. RESULTADOS: Veinte pacientes del grupo 1, 22 pacientes del grupo 2, 29 pacientes del grupo 3 completaron el estudio. Los gráficos de Kaplan-Meier no mostraron diferencias en las tasas de SLR y SLP entre los tres grupos. El análisis de regresión de Cox demostró que solo se encontró que el número de tumores era un factor pronóstico en las tasas de RFS. CONCLUSIÓN: Nuestro estudio prospectivo demostró que los lapsos de tiempo desde la RTU inicial hasta la nueva RTU no afectaron significativamente las tasas de SLR y SLP.

Effect of the COVID-19 Pandemic on Radical Prostatectomy: A Turkish Multicenter Study.

OBJECTIVE: The present study examines the effects of the coronavirus disease 2019 pandemic on radical prostatectomy performed as part of localized prostate cancer treatment in Turkey. MATERIAL AND METHODS: A retrospective analysis was made of the data of 176 patients from 8 centers in Turkey who underwent radical prostatectomy due to localized prostate cancer over the 2 years spanning March 1, 2019, to February 28, 2021. Within this timeframe, March 1, 2019, to February 28, 2020, was denoted the 1-year pre-coronavirus disease 2019 period, while March 1, 2020, to February 28, 2021, was denoted the 1-year coronavirus disease 2019 period. An analysis was made of whether there was a difference in the number of radical prostatectomies performed for prostate cancer, the time from biopsy to operation, and the biopsy and radical prostatectomy pathology between the 2 periods. RESULTS: It was found that the number of radical prostatectomies performed for localized prostate cancer during the coronavirus disease 2019 pandemic was statistically and highly significantly fewer than in the pre-coronavirus disease 2019 period (P <.001). The patients diagnosed with Gleason 3+3 (low risk) prostate cancer were statistically significantly fewer in number in the coronavirus disease 2019 period (P <.001). The pathological Gleason score was upgrading than the biopsy Gleason score in all patients who underwent in both periods (P <.001). When the periods were compared, the pathological involvement determined by lymph node dissection performed during radical prostatectomy was found to be decreased in the coronavirus disease 2019 period, although the difference was not statistically significant (P =.051). CONCLUSION: As with many diseases, the diagnosis and treatment of prostate cancer have been adversely affected by the coronavirus disease 2019 pandemic.

The Effect of Health Literacy on Men Seeking Medical Attention for Erectile Dysfunction.

Objective In this study, we aimed to determine if there was any relationship between patients with erectile dysfunction (ED) who do not seek medical help at the hospitals and their health literacy (HL) levels. Materials and methods The study included 68 patients. Patients with a main complaint of ED were included in Group 1, and those with benign prostatic hyperplasia (BPH) or who requested an age-related check-up were included in Group 2. Questions 1-5 and 15 of the International Index of Erectile Function (IIEF)-15 scale evaluating erectile functions were collected as IIEF-6 for the purpose of this study. Severe ED was defined as having a score of 0-10, while moderate ED was defined as a score of 11-16. Both patients with severe and moderate ED were considered and included in the study. The European Health Literacy Scale (HLS-EU) and the Turkey Health Literacy Scale-32 (THLS-32) were used for the evaluation of HL. Results The HLS-EU person-specific mean index was found to be 37.22 ±5.29 in Group 1 and 30.46 ±6.32 in Group 2. The THLS-32 person-specific mean index was determined to be 37.68 ±5.41 in Group 1 and 30.94 ±6.13 in Group 2. In Group 1, 58.3% of patients were classified as having sufficient HL and 22.2% were classified as having excellent HL. In Group 2, 21.9% of patients were classified as having sufficient HL and 3.1% were classified as having excellent HL. Conclusions As societal income, education levels, and HL levels increase, ED will become more important to individuals, motivating them to seek timely medical attention, and thereby leading to earlier diagnoses of potential primary pathologies.

Current status of uro-oncology training during urology residency and the need for fellowship programs: An international questionnaire study.

OBJECTIVE: This study aimed to evaluate the opinions of urologists from different countries about uro-oncology education, fellowship programs, and approaches to different urological malignancies at different stages using a questionnaire. MATERIAL AND METHODS: A total of 207 urologists from 22 countries were sent a questionnaire containing 18 items by email. The questions were related to urologic oncology training provided during residency, acceptance of uro-oncology as a sub-branch, the necessity of certification for treatment and follow-up, fellowship program preferences, adequateness of the programs, and approach differences to the different stages of urological malignancies among the urologists from different countries. RESULTS: In total, 111 (53.62%) urologists who completed the questionnaire were enrolled in the study, and 40.54% of the urologists reported that the uro-oncology training during the residency period was not sufficient. Furthermore, 79.27% of the urologists reported opinions about acceptance of uro-oncology as a sub-branch. The ratio of urologists who undertake the treatment of patients with muscle-invasive bladder cancer (radical surgery and urinary diversion) and prostate cancer (radical prostatectomy, definitive radiation therapy, experimental local treatment, and hormonal therapy) is 27.92% and 37.83%, respectively. The urologists reported that they perform nephron-sparing surgery (NSS), radical nephrectomy (RN), and laparoscopic NSS/RN treatments in patients with localized renal cancer at the rates of 61.26%, 47.74%, and 25.22%, respectively. CONCLUSION: Uro-oncology training during the residency period seems to be inadequate in most of the countries, and a high number of the urologists tend to avoid high-volume operations and systemic treatments of uro-oncologic malignancies.

A Prediction Model of Operation Efficacy Using Protruding Prostate Lobe Volume in Patients Who Are Candidates for Transurethral Resection of Prostate.

PURPOSE: To create a prediction model that could preoperatively measure the success of the transurethral prostate resection (TURP) because of bladder outlet obstruction. METHODS: Patients aged 50-80 years applied with TURP were examined prospectively and evaluated in respect of the preoperative and postoperative values of maximum flow rate (Qmax), international prostate symptom score (IPSS), quality of life (QoL) score and post-voiding residual (PVR) urine amount. On the preoperative transabdominal ultrasonography, total prostate volume (TPV), and protruding prostate lobe volume (PPLV) were measured and the protruding ratio (PR), as the ratio of PPLV to TPV, was calculated. Based on the mean of the preoperative and postoperative Qmax difference (Qmax-D) value, Group 1 (n = 33) was defined as "low efficacy" and Group 2 (n = 30) as "high efficacy". RESULTS: A correlation was determined between the QMax-D, IPSS difference, PVR difference, and QoL difference measured for the efficacy of the operation, and TPV, PPLV and PR. The results of multivariate analysis showed the main effect to be created by PR (p = 0.000; OR 1.596). In the evaluation with receiver operating characteristic curve analysis of high efficacy obtained in the TURP, a significantly powerful effect of the measurements of PPLV area under curve (AUC 0.922 [0.855-0.989] p= 0.000) and PR (AUC 0.954 [0.982-1.000] p = 0.000) was determined. The cutoff value of 11.5 was detected for PR. Efficacy sensitivity and the positive predictive values were recorded as 93.3%, and specificity and negative predictive value as 93.9%. CONCLUSION: When determining candidate patients for TURP surgery, measurements of the PPLV and especially the PR should be taken into consideration in the preoperative prediction of efficacy.

Risk Factors for Infectious Complications in Patients Undergoing Retrograde Intrarenal Surgery.

OBJECTIVE: To investigate the risk factors that may cause urinary tract infection (UTI) in patients applied with retrograde intrarenal surgery (RIRS). STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Departments of Urology, Ankara Training and Research Hospital, Turkey, from September 2014 to April 2017. METHODOLOGY: A retrospective examination was made of patients who underwent RIRS. The patients were separated into 2 groups as those with no UTI in the postoperative period (Group 1) and those with UTI (Group 2). The groups were compared in respect of age, stone size, operating time, presence of residual stone, and body mass index. Continuous independent variables were compared using the Student's t-test and in the comparison of categorical variables, the Chisquare test was used. A value of p<0.05 was accepted as statistically significant. RESULTS: Group 1 comprised 169 patients with no UTI and Group 2, 20 patients with UTI. The mean operating time was 55.82 ±14.73 minutes in Group 1 and 75.5 ±23.9 minutes in Group 2 (p=0.002). In multivariate analysis, operating time was determined as an independent prognostic risk factor increasing the risk of infection (p=0.001). The cut-off value determined with ROC analysis was 61 minutes. When operating time exceeded 61 minutes, the infection risk was increased 11.1-fold (sensitivity 75%, specificity 76%, AUC 0.76). CONCLUSION: Operating time in patients applied with RIRS was determined to be an independent prognostic risk factor for UTI risk in the postoperative period. In patients where surgery lasts more than 1 hour, particular attention should be paid in respect of infection risk.

Comparision of Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery For The Treatment of Multicalyceal and Multiple Renal Stones.

PURPOSE: Comparison of efficiency and reliability of percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) in treatment of multicalyceal and multiple renal stones in the same renal unit. MATERIALS AND METHODS: Between 2011 and 2015, records of patients who underwent surgery for renal stone were retrospectively reviewed. Patients who had multiple stones located in different calices in the same renal unit were included. The patients that underwent PNL and RIRS were defined as Group I and Group II, respectively. Patient criteria (age,sex); the stone characteristics; time of procedure, fluoroscopy and hospitalization; stone-free and complication rates of groups were evaluated between the treatment groups. RESULT: There were no significant differences in terms of age, gender, BMI, laterality, number of stones, number of stone localization, hounsfield units and surface area characteristics of the stone between the PNL (n = 47) and RIRS (n = 35) groups (P = .558, P = .278, P = .375, P = 0.051, P = .053, P = .064, P = .642, P = .080, respectively). Stone free rate was 59.6% (n=28) in PNL, and 88.6% (n=31) in RIRS (P=.004). 1st or 2nd degree complications according to Modified Clavien Classification developed in 10 patients (21.3%) in Group I and 1 patient (2.9%) in Group II (P = .015). The 3A or 3B complications were similar in groups (P = .077). Time of procedure, fluoroscopy and hospitalization were significantly lower in Group II (P < .001, P < .001 and P < .001, respectively). CONCLUSION: RIRS is more effective and more reliable procedure than PNL with higher stone-free and lower complication rates in treatment of multicalyceal and multiple stone in the same renal unit.

The protective effect of Papaverine and Alprostadil in rat testes after ischemia and reperfusion injury

ABSTRACT Objective: To investigate the effect of papaverine and alprostadil on testicular torsion-detorsion injury in rats. Materials and Methods: A total of 40 male Wistar-Albino rats were used in this study. Four hours of right testicular torsion was applied to each group, excluding sham oper- ated group. The torsion-detorsion (T/D), T/D + papaverine and T/D + alprostadil groups received saline, papaverine and alprostadil at the same time as surgical detorsion, respectively. At 14 days after the surgical detorsion, ischaemic changes and the degree of damage were evaluated with Cosentino scoring and the Johnson tubular biopsy score (JTBS). Results: JTBS was determined as 8.8±2.7 in the Sham group, 5.08±1.9 in the T/D+papaverine group, 5.29±2.3 in the T/D +alprostadil group and 2.86±1.9 in the TD group. The JTBS was determined to be statistically significantly high in both the T/D + papaverine group and the T/D + alprostadil group compared to the T/D group (p=0.01, p=0.009). In the T/D + papaverine group, 3 (43%) testes were classified as Cosentino 2, 3 (43%) as Cosentino 3 and 1 (14%) as Cosentino 4. In the T/D +alprostadil group, 5 (50 %) testes were classified as Cosentino 2, 3 (30 %) as Cosentino 3 and 2 (20%) as Cosentino 4. Conclusion: The present study indicated that spermatic cord administration of alprostadil and papaverine showed a protective effect against ischemia/reperfusion injury after right-side testes torsion and histological changes were decreased after testicular ischemia reperfusion injury.

The protective effect of Papaverine and Alprostadil in rat testes after ischemia and reperfusion injury.

OBJECTIVE: To investigate the effect of papaverine and alprostadil on testicular torsion-detorsion injury in rats. MATERIALS AND METHODS: A total of 40 male Wistar-Albino rats were used in this study. Four hours of right testicular torsion was applied to each group, excluding sham operated group. The torsion-detorsion (T/D), T/D + papaverine and T/D + alprostadil groups received saline, papaverine and alprostadil at the same time as surgical detorsion, respectively. At 14 days after the surgical detorsion, ischaemic changes and the degree of damage were evaluated with Cosentino scoring and the Johnson tubular biopsy score (JTBS). RESULTS: JTBS was determined as 8.8±2.7 in the Sham group, 5.08±1.9 in the T/ D+papaverine group, 5.29±2.3 in the T/D +alprostadil group and 2.86±1.9 in the TD group. The JTBS was determined to be statistically significantly high in both the T/D + papaverine group and the T/D + alprostadil group compared to the T/D group (p=0.01, p=0.009). In the T/D + papaverine group, 3 (43 %) testes were classified as Cosentino 2, 3 (43%) as Cosentino 3 and 1 (14 %) as Cosentino 4. In the T/D +alprostadil group, 5 (50 %) testes were classified as Cosentino 2, 3 (30 %) as Cosentino 3 and 2 (20%) as Cosentino 4. CONCLUSION: The present study indicated that spermatic cord administration of alprostadil and papaverine showed a protective effect against ischemia/reperfusion injury after right-side testes torsion and histological changes were decreased after testicular ischemia reperfusion injury.

Does Preoperative Use of Dutasteride Decrease Bleeding During Open Prostatectomy?

PURPOSE: To investigate whether use of dutasteride, a 5-alpha reductase inhibitor, for at least four weeks preoperatively affected the blood loss during open prostatectomy (OP). MATERIALS AND METHODS: Retrospective analysis was made of the data of 110 patients who had undergone OP. Group I comprised 50 patients that used dutasteride for 4 weeks preoperatively, and Group II comprised 60 patients that did not use the drug. The groups were compared in respect of age, total prostate specific antigen (TPSA) levels, prostate volumes, preoperative hemoglobin (Hgb) and hematocrit (Hct) levels, postoperative reduction of Hgb and Hct, percentage reduction in Hgb and Hct, and the administration of postoperative blood products. RESULTS: No differences were determined between the two groups in respect of prostate volumes, TPSA, preoperative Hgb and Hct levels (P = .813, P = .978, P = .422, P =.183, respectively). Postoperative Hgb reduction was 2.19 ± 1.36 g/dL in Group I, and 2.5 ± 1.47 g/dL in Group II (P = .260). Hgb reduction was calculated as 16.4 ± 9.7% in Group I and 17.6 ± 9.7% in Group II (P = .505). Reductions in Hct were 5.8 ± 3.7% in Group I, and 7.3 ± 4.4% in Group II, and percent reductions were 14.8 ± 9.4% in Group I and 17.3 ± 10.2% in Group II (P = .068, P = .182, respectively). CONCLUSION: The use of dutasteride before OP did not affect blood loss during surgery, therefore surgery should not be delayed for the administration of dutasteride to patients.

The Respiratory Induced Kidney Motion: Does It Really Effect the Shock Wave Lithotripsy?

PURPOSE: To investigate the effect of respiratory induced kidney mobility on success of shock wave lithotripsy (SWL) with an electrohydraulic lithotripter. MATERIALS AND METHODS: Between May 2013 and April 2015, 158 patients underwent SWL treatment for kidney stones with an electrohydraulic lithotripter. The exclusion criteria were presence of a known metabolic disease (such as cystinuria), non-opaque stones, need for focusing with ultrasonography, abnormal habitus, urinary tract abnormalities, and inability to tolerate SWL until the end of the procedure. Stones greater than 20 mm, and lower pole stones were also excluded. The movement of the kidneys were measured with fluoroscopy guidance. RESULTS: The procedure was successful in 66.7% of the males, and 56.9% of the females. The mean stone size was 11 ± 3 mm in the successful group, and it was 14 ± 4 mm in the unsuccessful group. The mean stone mobility rate was 32 ± 10 in the successful group and 40 ± 11 in the unsuccessful group. Multivariate analysis showed that stone size and kidney mobility affected the success rate significantly, however Hounsfield Unit (HU) did not. CONCLUSION: The current study shows the significant effect of kidney motion on the success of SWL. Further studies with different lithotripters are needed to determine the significance of kidney mobility.

Comparison of tubularized incised plate urethroplasty and onlay island flap urethroplasty techniques in the repair of primarily proximal hypospadias.

OBJECTIVES: To compare the success of the 'tubularized incised plate urethroplasty' (TIPU) and 'Onlay island flap urethroplasty' (OIFU) techniques for the repair of primary proximal hypospadias. MATERIAL AND METHODS: A retrospective evaluation was made of the medical records of 68 patients with primary, non-complicated hypospadias, who were operated on in the Department of Urology, Ministry of Health Ankara Education and Research Hospital, between January 1997 and December 2012. Patients who underwent hypospadias surgery with TIPU were labelled as Group 1 and the OIFU technique as Group 2. Patient age, native meatus localization, operation time, diversion type, surgical success and complication rates were all assessed. Surgical success was evaluated with direct vision of voiding and uroflowmetry at the time of catheter removal, then at 2 weeks, 6 weeks, 6 months and 1 year. RESULTS: Group 1 consisted of 43 patients and Group 2 of 25 patients. The mean age of patients was 6.4±3.1 years in Group 1 and 8.0±4.6 years in Group 2 (p=0.09). The mean operating time was significantly lower in Group 1. (Group 1- 104.8±16.8 min, Group 2-125.4±24.7min; p<0.001) The distribution of meatus localization was similar in both groups. At 1 year postoperatively, urethrocutaneous fistula was the only complication and the definitive success rates were 81.6% in Group 1 and 72% in Group 2. CONCLUSION: Despite less frequent usage since the description and popularization of TIPU for proximal hypospadias repair, OIFU remains a valuable technique as a single-stage procedure in cases where the urethral plate is insufficient. Currently, both TIPU and OIFU are used successfully in the treatment of patients with proximal hypospadias.

Comparison of tubularized incised plate urethroplasty and onlay island flap urethroplasty techniques in the repair of primarily proximal hypospadias / Comparación entre la uretroplastia tubularizada con incision de la placa uretral y las técnicas de Uretroplastia con colgajo pediculado para la reparación del hipospadias proximal primario

OBJECTIVES: To compare the success of the "tubularized incised plate urethroplasty" (TIPU) and "Onlay island flap urethroplasty" (OIFU) techniques for the repair of primary proximal hypospadias. MATERIAL AND METHODS: A retrospective evaluation was made of the medical records of 68 patients with primary, non-complicated hypospadias, who were operated on in the Department of Urology, Ministry of Health Ankara Education and Research Hospital, between January 1997 and December 2012. Patients who underwent hypospadias surgery with TIPU were labelled as Group 1 and the OIFU technique as Group 2. Patient age, native meatus localization, operation time, diversion type, surgical success and complication rates were all assessed. Surgical success was evaluated with direct vision of voiding and uroflowmetry at the time of catheter removal, then at 2 weeks, 6 weeks, 6 months and 1 year. RESULTS: Group 1 consisted of 43 patients and Group 2 of 25 patients. The mean age of patients was 6.4±3.1 years in Group 1 and 8.0±4.6 years in Group 2 (p = 0.09). The mean operating time was significantly lower in Group 1. (Group 1- 104.8±16.8 min, Group 2-125.4±24.7min; p < 0.001) The distribution of meatus localization was similar in both groups. At 1 year postoperatively, urethrocutaneous fistula was the only complication and the definitive success rates were 81.6% in Group 1 and 72% in Group 2. CONCLUSION: Despite less frequent usage since the description and popularization of TIPU for proximal hypospadias repair, OIFU remains a valuable technique as a single-stage procedure in cases where the urethral plate is insufficient. Currently, both TIPU and OIFU are used successfully in the treatment of patients with proximal hypospadias

OBJETIVOS: Comparar las tasas de éxito de las técnicas de Uretroplastia tubularizada con incisión de la placa uretral (TIP) y la Uretroplastia con colgajo en la reparación del hipospadias primario proximal. MÉTODOS: Realizamos una evaluación retrospectiva de las historias clínicas de 68 pacientes con hipospadias primario no complicado, que fueron operados en el departamento de Urología del Ministry of Health Ankara Education and Research Hospital entre enero del 1997 y diciembre del 2012. El grupo 1 incluyó los pacientes intervenidos de hipospadias mediante la técnica TIP y el grupo 2 los pacientes intervenidos con la técnica de colgajo no pediculado. Se evaluaron la edad del paciente, la localización del meato nativo, el tiempo operatorio, el tipo de derivación, el éxito de la operación y las complicaciones. El éxito de la operación fue evaluado con visión directa de la micción y flujometría en el momento de la retirada de la sonda, y posteriormente a las dos y seis semanas, a los 6 meses y al año. RESULTADOS: El grupo 1 incluía 43 pacientes y el grupo 2 25. La edad media de los pacientes fue 6,4 ± 3,1 años en el grupo 1 y 8,0 ± 4,6 años en el grupo 2 (p = 0,09). El tiempo medio operatorio fue significativamente menor en el grupo 1. (Grupo 1- 104,8 ± 16,8 min, Grupo 2-125,4 ± 24,7min; p < 0,001). La distribución de la localización del meato fue similar en ambos grupos. Al año de la operación, la única complicación fue fístula uretrocutánea y la tasa de éxitos era de 81,6% en el Grupo 1 y 72% en el Grupo 2. CONCLUSIONES: A pesar del menor uso desde la descripción y popularización de la Uretroplastia TIP para la reparación del hipospadias proximal, la Uretroplastia con colgajo sigue siendo una técnica válida como procedimiento único en casos en los que la placa uretral es insuficiente. Actualmente, ambas técnicas de uretroplastia, TIP y con colgajo, se utilizan con éxito en el tratamiento de pacientes con hipospadias proximal

Should manual detorsion be a routine part of treatment in testicular torsion?

BACKGROUND: It was aimed to investigate the efficiency and reliability of the manual detorsion (MD) procedure in patients diagnosed with testicular torsion (TT). METHODS: A retrospective analysis was made of the data of 57 patients diagnosed with TT, comprising 20 patients with successful MD (Group I), 28 patients who underwent emergency orchiopexy (Group II), and 9 patients applied with orchiectomy (Group III). The groups were compared in respect of age, and duration of pain. The success rate of MD, the time of testicular fixation (TF), any problems encountered in follow-up, and follow-up times were analyzed in Group I. Data were analyzed with P-P pilot, Mann-Whitney U, Kruskal Wallis and Chi-square tests. A value of p < 0.05 was considered statistically significant. RESULTS: MD was successful and detorsion could be achieved in 20 of 26 patients. The groups were similar in respect of age (p = 0.217). The median duration of pain was 3 (1-8), 4 (1-72), and 48 (12-144) hours in Groups I, II, and III, respectively, and determined as similar in Groups I and II (p = 0.257), although a statistically significant difference was determined between the 3 groups (p < 0.001). TF was applied to Group I after median 10 (0-45) days, and no parenchymal disorder was determined in the median follow-up period of 21.5 (2-40) months. CONCLUSION: MD that can be easily and immediately performed after the diagnosis of TT decreases ischemia time. This seems to be an efficient and reliable procedure when applied together with elective orchiopexy, as a part of the treatment.

Comparison of ultra-mini percutaneous nephrolithotomy and micro-percutaneous nephrolithotomy in moderate-size renal stones.

OBJECTIVE: We aimed to compare the success and complications of ultra-mini percutaneous nephrolithotomy and micro-percutaneous nephrolithotomy techniques. METHODS: We retrospectively analyzed data from 74 patients. Moderate-size stones were included in the study. RESULTS: Forty-two patients were included in MPNL, and 32 patients were included in UPNL groups. Among our patient cohort, 42 (56.7%)were males, and 32 (43.3%) were females. The mean age of the patients was 40±13.2 years in the MPNL group, and the mean age of the patients was 42±14.1 years in the UPNL group. The mean stone size was 17±3.2 mm in the MPNL group and 16.4±3.7 mm in the UPNL group. The stonefree rates were 88.1% (37/42) and 90.6% (29/32)in the MPNL and UPNL groups, respectively; there was no statically significant difference between the groups. The mean hospital stay was 1.4±0.23 days in the MPNL group and 1.1±0.12 day in the UPNL group. CONCLUSIONS: Two techniques have similar success and complication rates, and both may be preferred particularly in moderate-size stones. Our experience supports that our UPNL technique is safe and effective using with a standard ureteroscope.

Comparison of ultra-mini percutaneous nephrolithotomy and micro-percutaneous nephrolithotomy in moderate-size renal stones / Comparación de la nefrolitotomía percutánea ultra-mini y micro-nefrolitotomía percutánea en cálculos renales de tamaño moderado

OBJECTIVE: We aimed to compare the success and complications of ultra-mini percutaneous nephrolithotomy and micro-percutaneous nephrolithotomy techniques. METHODS: We retrospectively analyzed data from 74 patients. Moderate-size stones were included in the study. RESULTS: Forty-two patients were included in MPNL, and 32 patients were included in UPNL groups. Among our patient cohort, 42 (56.7%) were males, and 32 (43.3%) were females. The mean age of the patients was 40±13.2 years in the MPNL group, and the mean age of the patients was 42±14.1 years in the UPNL group. The mean stone size was 17±3.2 mm in the MPNL group and 16.4±3.7 mm in the UPNL group. The stonefree rates were 88.1% (37/42) and 90.6% (29/32) in the MPNL and UPNL groups, respectively; there was no statically significant difference between the groups. The mean hospital stay was 1.4±0.23 days in the MPNL group and 1.1±0.12 day in the UPNL group. CONCLUSIONS: Two techniques have similar success and complication rates, and both may be preferred particularly in moderate-size stones. Our experience supports that our UPNL technique is safe and effective using with a standard ureteroscope

OBJETIVO: Comparar las tasas de éxito y las complicaciones de las técnicas ultra-mini nefrolitotomia percutánea (UNLP) y micro Nefrolitotomía percutánea (MNLP). MÉTODOS: Analizamos retrospectivamente los datos de 74 pacientes. Se incluyeron en el estudio litiasis de tamaño moderado. RESULTADOS: Cuarenta y dos pacientes se incluyeron en el grupo de MNLP y 32 pacientes en el de UNLP. En nuestra cohorte de pacientes, 42 (56,7%) eran varones y 32 (43,3%) mujeres. La edad media de los pacientes fue de 40±13,2 años en el grupo de MNLP y 42±14,1 años en el grupo de UNLP. El tamaño medio de la litiasis fue de 17±3,2 mm en el grupo de MNLP y 16,4±3,7 mm en el grupo de UNLP. Las tasas de pacientes libres de litiasis fueron del 88,1% (37/42) y 90,6% (29/32) en los grupos de MNLP y UNLP, respectivamente; no había diferencias estadísticamente significativas entre los grupos. La estancia hospitalaria media fue de 1,4±0,23 días en el grupo de MNLP y 1,1±0,12 días en el de UNLP. CONCLUSIONES: Las dos técnicas tienen tasas de éxito y de complicaciones similares, y ambas pueden ser las preferidas para litiasis de tamaño moderado. Nuestra experiencia apoya que nuestra técnica de UNLP es segura y efectiva utilizando un ureteroscopio estándar