Effect of internet pornography use frequency on psychogenic erectile dysfunction severity in young Turkish men: the mediating role of dyadic adjustment.

This cross-sectional study aimed to investigate the effect of the frequency of using pornography on psychogenic erectile dysfunction severity after controlling for other psychological factors. It then evaluated the mediating role of dyadic adjustment regarding this. This study included 66 young married heterosexual male patients who were diagnosed with psychogenic erectile dysfunction after organic causes were excluded. The patients filled out the form about demographics, the age of onset of pornography use, and the frequency of pornography use. All participants were evaluated using a comprehensive data form, the International Index of Erectile Function, the Dyadic Adjustment Scale, the Patient Health Questionnaire-Somatic, Anxiety, and Depressive Symptoms, the Perceived Stress Scale, and the Rosenberg Self-Esteem Scale. A significant strong negative correlation was determined between the International Index of Erectile Function scores and pornography use frequency (r = -0.535 and p < 0.001). Pornography use frequency and Dyadic Adjustment Scale scores were found to have a significant predictive effect on erectile dysfunction scores in hierarchical regression analysis after controlling for somatization, depression, and perceived stress, which are typically correlated with erectile dysfunction scores (Beta = -0.28, and 0.34 respectively, p = 0.02, and 0.01 respectively). The Sobel test conducted to evaluate the mediating effect of dyadic adjustment revealed that dyadic adjustment played a mediating role in the correlation between pornography use frequency and erectile dysfunction scores (z = -1.988 and p = 0.047, respectively). The most significant observation of this study was the specific causative effect of pornography use frequency on erectile dysfunction severity through dyadic adjustment, especially considering that the frequency of using pornography is a modifiable factor.

The Clinical Impact of Physical Activity on the Diagnosis of Prostate Cancer and Postprostatectomy Functional Outcomes in the Elderly.

Objectives: The effect of physical activity on prostate cancer is controversial. We aimed to investigate the effect of physical activity on prostate cancer detection and functional outcomes after radical prostatectomy. Methods: Between 2019 and 2020, 166 patients who underwent prostate biopsy were included. The physical activity scores of patients were evaluated by the Physical Activity Scale for the Elderly (PASE) questionnaire before the procedure. PASE scores were compared between the patients with and without prostate cancer and local and metastatic aggressiveness of cancer. Patients who underwent radical prostatectomy were followed up for 12 months to analyze the effect of physical activity on erectile dysfunction (ED) and urinary incontinence (UI). Results: There was no significant difference between patients with and without prostate cancer in terms of PASE scores (187.7 vs. 195.5, p=0.665). PASE scores were also similar when separated according to D'Amico risk classification and metastatic events. Twenty-seven patients who underwent radical prostatectomy were evaluated in terms of functional outcomes at the first year of surgery. PASE scores of the patients with severe ED were lower than mild-moderate ED, but no statistically significant difference was observed (197.0 vs. 268.5, p=0.267). Patients with persistent UI had a significantly lower PASE score overall than continent patients (128.3 vs. 271.1, p=0.001), and PASE score was the only independent predictor of UI following radical prostatectomy. Conclusion: The effect of physical activity on prostate cancer development or aggressiveness could not be determined. Physical activity was associated with a reduced risk of UI following radical prostatectomy.

Management of Priapism: Results of a Nationwide Survey and Comparison with International Guidelines.

OBJECTIVE: The aim of this study is to evaluate current urologic practice regarding the management of priapism in Turkey and compare with international guidelines. METHODS: Urologists and urology residents were invited to an online survey consisting of 30 multiple-choice questions on priapism-related clinical practices that were consid- ered most important and relevant to practices by using Google Forms. RESULTS: Total number of responses was 340. Respondents reported that they recorded a detailed patient's medical history and physical examination findings (n = 340, 100%) and laboratory testing, which includes corporal blood gas analysis (n=323, 95%). Participants announced that they performed Doppler ultrasound for 1/4 cases (n = 106, 31%), but 22% of the participants (n=75) replied that they performed in >75% of cases. Participants (n=311, 91%) responded that the first-line treatment of ischemic priapism is decompression of the corpus cavernosum. Moreover, most respondents (n = 320, 94%) stated that sympathomimetic injection drugs should be applied as the second step. About three-quarters of respondents (n = 247, 73%) indicated adrenaline as their drug of choice. Phosphodiesterase type 5 inhibitors seems to be the most pre- ferred drug for stuttering priapism (n=141, 41%). Participants (n=284, 84%) replied that corpora-glanular shunts should be preferred as the first. A large number of par- ticipants (n = 239, 70%) declared that magnetic resonance imaging can be performed in cases with delayed (>24 hours) priapism to diagnose corporal necrosis. Most of the participants (84%) responded that penile prosthesis should be preferred to shunts in cases with delayed (>48 hours) priapism. CONCLUSION: It would be appropriate to improve the training offered by professional associations and to give more training time to the management of priapism during residency.

Distinct Adverse Clinical Outcomes of Small and Large Cribriform Patterns on Gleason 7 Prostate Cancer: A Preliminary Study.

OBJECTIVE: We aimed to evaluate the effect of large and small cribriform morphology on survival following radical prostatectomy. METHODS: We included 30 patients who underwent radical prostatectomy with curative intent between 2015 and 2022. Patients with the final pathology of Gleason 7 were included. Patients' radical prostatectomy specimens were reviewed by an experienced genitourinary pathologist. The diverse growth patterns of Gleason grade 4 were specified as poorly formed/fused glands, cribriform glands, and glomeruloid glands. The cribriform morphology was subdivided into small and large cribriform. Large cribriform growth morphology was defined by its size, which was double that of benign prostate glands. Small and large cribriform glands' percentages were indicated semiquantitatively. The cribriform morphology subtype present at 50% and higher was defined as the dominant pattern. The effect of histopathological patterns on biochemical recurrence and clinical progression was analyzed. RESULTS: Thirteen patients were small cribriform pattern dominant (group 1), whereas 14 of the patients were large cribriform pattern dominant (group 2). Pathological T, N stages, and surgical margin positivity were similar between groups. Biochemical recurrence and clinical progression rates were significantly higher in group 2. The large cribriform dominant patients had worse 2-year biochemical recurrence-free survival than small cribriform dominant patients (45.5% vs. 66.7%). In the univariate analysis, International Society of Urological Pathology grade, Gleason pattern 4 percentage, large cribriform pattern dominancy, and pT stage were predictors for biochemical recurrence-free survival. International Society of Urological Pathology grade was the only independent predictor for biochemical recurrence-free survival. CONCLUSION: Large cribriform pattern dominancy is associated with worse biochemical recurrence-free survival in Gleason 7 prostate cancer.

Factors influencing the decision-making in laparoscopic partial nephrectomy for small renal masses.

BACKGROUND AND OBJECTIVES: We analyzed the factors affecting the decision on surgical approach such as hilum dissection, vessel clamping, and the warm ischemia time (WIT) in laparoscopic partial nephrectomy (LPN) for small renal masses (SRMs). METHODS: Patients who underwent LPN for SRMs between 2011 and 2021 in two centers were retrospectively screened. Standardized R.E.N.A.L. nephrometry score (RNS) and each of the components were scored on a Likert scale and the effect on the surgical approach was examined by using them separately. RESULTS: A total of 133 patients, 85 of whom were on-clamp and 48 were off-clamp, were included in the study. Greater tumor size, low BMI, higher RNS, upper pole tumor, low exophytic rate, and nearness to the collecting system were statistically significant for both on/off-clamp and hilar dissection decisions. In multivariate analysis, greater tumor size, upper pole tumor, lower rate of exophytic part (E2), nearness to the collecting system (N3) were independent risk factors for vessel clamping. Greater tumor size and lower exophytic tumor rate (E2) were independent risk factors for hilum dissection. We could not identify any factor affecting WIT. CONCLUSION: Individual components of RNS may serve as a better tool for decision-making on vessel clamping and hilum dissection during LPN for SRMs.

The cribriform morphology impairs Gleason 7 prostate cancer lesion detection on multiparametric magnetic resonance imaging.

BACKGROUND: Prostate multiparametric magnetic resonance imaging (mpMRI) is a useful tool for the detection of tumor lesions however, some clinically significant lesions are still missed. We determined whether the cribriform pattern has an effect on lesion detection in mpMRI. METHODS: We reviewed the single-institution database of the patients who underwent mpMRI before radical prostatectomy. We included the patients only with the Gleason 7 final pathology of open radical prostatectomy with curative intent between 2016 and 2021. Prostatectomy mappings according to the 16-sector map and cribriform patterns were re-evaluated by two genitourinary pathologists. Prostate mpMRIs were read by two genitourinary radiologists. If the index and nonindex lesions in pathology mapping were matched with mpMRI as Prostate Imaging Reporting and Data System-3 or higher, it was defined as detectable. We compared the detection rates of lesions with and without cribriform morphology. In regression analysis, we also assessed the factors affecting the detectability of prostate cancer lesions. RESULTS: A total of 120 patients and 157 lesions were included in our study. While 52 of 83 cribriform pattern positive lesions could be detected in mpMRI, 59 of 74 cribriform pattern negative lesions could be detected (62.7% vs. 79.7%, respectively, p = 0.019). The lesions were also distributed homogeneously according to diameters and analyzed separately. All lesions between 21 and 30 mm with the negative cribriform pattern were detected on mpMRI. However, only 77.8% of cribriform pattern positive lesions between 21 and 30 mm could be detected (p = 0.034). The Higher D'Amico risk group and the absence of cribriform morphology were independent predictors for the lesion detection on mpMRI. CONCLUSION: The presence of cribriform pattern in Gleason 7 prostate cancer lesions decreases the lesion detection rate of mpMRI.

The association between PI3K, JAK/STAT pathways with the PDL-1 expression in prostate cancer.

Programmed cell death protein-1/programmed death-ligand-1 (PD-1/PDL-1) signalling pathway has gained attention in prostate cancer. The relationship between pSTAT-1, pSTAT-3 expressions and PTEN loss with PDL-1 expression was assessed and the effects of the pathways on prostate cancer prognosis were evaluated. Patients who underwent radical prostatectomy between 2011 and 2017 were included in our study. Prostatectomy materials were evaluated using immunohistochemical staining of pSTAT-1, pSTAT-3, PTEN, and PDL-1. The relationship between PDL-1 and pSTAT-1, pSTAT-3 expressions and PTEN loss was evaluated. Additionally, factors affecting biochemical recurrence-free survival and clinical progression-free survival were analysed. Within100 patients, 9 of 11 patients with PDL-1 expression also had intermediate-high pSTAT-1 staining intensity, and those with PDL-1 expression had higher pSTAT-1 staining intensity than those without (81.9% vs. 56.2%, p = 0.014). In univariate analysis, pSTAT-1, pSTAT-3 and PDL-1 expressions had significant impact on biochemical recurrence-free and clinical progression-free survival. In multivariate analysis, pSTAT-1 staining intensity with radical prostatectomy ISUP grade in terms of biochemical recurrence-free survival and the pSTAT-1 H-score with radical prostatectomy ISUP grade in terms of clinical progression-free survival were independent risk factors. Moderate-high expression of pSTAT-1 was closely associated with PDL-1 expression, and pSTAT-1 was also a predictor of biochemical recurrence and clinical progression.

The Role of Preoperative Urinalysis in Predicting Postoperative Infection After Retrograde Intrarenal Surgery in Patients with Sterile Urine Culture.

OBJECTIVE: Postoperative urinary tract infection is the most common complication of retrograde intrarenal surgery, and no consensus has been obtained that would reveal exact reasons yet. It was aimed to determine the possible factors, especially preoperative urinalysis, of postoperative urinary tract infection after retrograde intrarenal surgery. MATERIAL AND METHODS: Patients who underwent retrograde intrarenal surgery in our clinic between 2013 and 2019 were retrospectively screened. Stone size 2 cm and pediatric patients were excluded from the study. The patients were divided into 2 groups as those with and without urinary infections in the early postoperative period. Urine analysis parameters and sterile urine cultures that were taken before the procedure were also analyzed separately. RESULTS: A total of 289 patients meeting the defined criteria were included in the study. There was no statistical difference between the 2 groups in terms of demographics. The number of patients with previous urinary tract infection history (55% vs. 20.5%) and operation time (62.5 ± 16.6 minutes vs. 60 ± 19.4 minutes) were significantly higher in those who had postoperative early urinary tract infection. Among urinalysis, the presence of pyuria, leukocyte count, leukocyte esterase positivity, and nitrite positivity were significantly higher in those who had postoperative early urinary tract infection. In multivariate analysis, urinary tract infection history, operation time, and nitrite positivity were found as independent factors in predicting postoperative early urinary tract infection. CONCLUSION: Previous urinary tract infection history, prolonged operation time, and nitrite positivity in urinalysis were determined as independent risk factors for postoperative urinary tract infection in kidney stones between 1 and 2 cm.

Effects of androgen deprivation therapy on metabolic markers and bioelectrical impedance analyze in prostate cancer patients / Efectos de la terapia de privación de andrógenos sobre marcadores metabólicos y análisis de impedancia bioeléctrica en pacientes con cáncer de próstata

Introduction and Objectives: Prostate cancer (PCa) is the most widespread malignancy within men. Androgen deprivation therapy (ADT), which is the central component of advanced PCa treatment, causes side effects. The goal of this study was to examine the metabolic changes and bioelectrical impedance analysis differences in PCa patients who received ADT.Materials and methods: After age-related match-pair analysis, a total of 519 patients with PCa and control group who had benign disease were enrolled in the study. Biochemical blood parameters and TANITA measurements were recorded for all patients. Patients were categorized into three groups, ADT group (Group 1, n=124) and non-ADT group (Group 2, n=248), control group (Group 3, n=147).Results: The mean age of groups was similar. Body mass index, waist circumference, body fat mass and fat ratio, which were among the TANITA parameters, were higher in group 1 (p<0.05). Total cholesterol, high density lipoprotein, non- high density lipoprotein, triglycerids and fasting blood glucose values were also higher in group 1 (p<0.05). Myocardial infarction and metabolic syndrome rates were also higher in this group.Conclusions: While the use of ADT is manifested by an increase in fat mass and fat ratio in body composition, it negatively affects waist circumference measurements. It is associated with metabolically unfit body composition changes that predispose to diabetes mellitus and may increase cardio-vascular disease. For this reason, it is necessary to be careful about metabolic and endocrinological diseases in long-term therapy. (AU)

Introducción y objetivos: El cáncer de próstata (CaP) es la neoplasia maligna más extendida en los hombres. La terapia de privación de andrógenos (ADT), que es el componente central de su tratamiento avanzado, causa efectos secundarios. El objetivo de este estudio fue examinar los cambios metabólicos y las diferencias de análisis de impedancia bioeléctrica en pacientes con CaP que recibieron ADT.Materiales y métodos: Después del análisis de pares de parejas relacionados con la edad, un total de 519 pacientes con CaP y un grupo de control con enfermedad benigna se inscribieron en el estudio. Se registraron parámetros sanguíneos bioquímicos y mediciones de TANITA para todos los pacientes. Los pacientes se clasificaron en 3 grupos: grupo ADT (grupo 1; n=124), grupo no ADT (grupo 2; n=248) y grupo control (grupo 3; n=147).Resultados: La edad media de los grupos fue similar. El índice de masa corporal, la circunferencia de la cintura, la masa de grasa corporal y la proporción de grasa, que se encontraban entre los parámetros de TANITA, fueron mayores en el grupo 1 (p<0,05). El colesterol total, las lipoproteínas de alta densidad, las lipoproteínas de baja densidad, los triglicéridos y los valores de glucosa en sangre en ayunas también fueron más altos en el grupo 1 (p<0,05). Las tasas de infarto de miocardio y síndrome metabólico también fueron más altas en este grupo.Conclusiones: Si bien el uso de ADT se manifiesta por un aumento en la masa grasa y la proporción de grasa en la composición corporal, en cambio, afecta negativamente las mediciones de circunferencia de la cintura. Se asocia con cambios en la composición corporal metabólicamente inadecuados que predisponen a la diabetes mellitus y pueden aumentar la enfermedad cardiovascular. Por esta razón, es necesario tener cuidado con las enfermedades metabólicas y endocrinológicas en la terapia a largo plazo. (AU)

Effects of androgen deprivation therapy on metabolic markers and bioelectrical impedance analyze in prostate cancer patients.

INTRODUCTION AND OBJECTIVES: Prostate cancer (PCa) is the most widespread malignancy within men. Androgen deprivation therapy (ADT), which is the central component of advanced PCa treatment, causes side effects. The goal of this study was to examine the metabolic changes and bioelectrical impedance analysis differences in PCa patients who received ADT. MATERIALS AND METHODS: After age-related match-pair analysis, a total of 519 patients with PCa and control group who had benign disease were enrolled in the study. Biochemical blood parameters and TANITA measurements were recorded for all patients. Patients were categorized into three groups, ADT group (Group 1, n=124) and non-ADT group (Group 2, n=248), control group (Group 3, n=147). RESULTS: The mean age of groups was similar. Body mass index, waist circumference, body fat mass and fat ratio, which were among the TANITA parameters, were higher in group 1 (p<0.05). Total cholesterol, high density lipoprotein, non- high density lipoprotein, triglycerids and fasting blood glucose values were also higher in group 1 (p<0.05). Myocardial infarction and metabolic syndrome rates were also higher in this group. CONCLUSIONS: While the use of ADT is manifested by an increase in fat mass and fat ratio in body composition, it negatively affects waist circumference measurements. It is associated with metabolically unfit body composition changes that predispose to diabetes mellitus and may increase cardio-vascular disease. For this reason, it is necessary to be careful about metabolic and endocrinological diseases in long-term therapy.

Prognostic and clinicopathologic value of ki-67 and profilin 1 immunohistochemical expression in primary pT1 urothelial bladder cancer.

PURPOSE: To investigate the prognostic and clinicopathologic value of Ki-67 and profilin 1 immunohistochemical expression in primary pT1 papillary urothelial bladder cancer. MATERIALS AND METHODS: This study included 88 male and 13 female pT1 primary bladder cancer patients. Demographic characteristics, tumor histological grade, tumor number, presence of concomitant carcinoma in situ, tumor size, and status of recurrence or progression were recorded for each patient. Expression of Ki-67 and profilin 1 was evaluated by immunohistochemical analysis of paraffin-embedded tumor tissues. The Pearson's Chi-square test was used for the analysis of qualitative data, and the Kaplan-Meier method and the log-rank test were used for the survival analysis. RESULTS: In the mean follow-up period of 52 months, 52 (51.5%) patients experienced recurrence, 24 (23.8%) patients experienced progression, and 17 (16.8%) patients died from bladder cancer-related causes. Ki-67 expression was significantly associated with tumor histological grade (P = 0.001). In multivariate analysis, Ki-67 positivity had significantly worse outcome for recurrence (P = 0.006) and mortality (P = 0.022). Ki-67-positive (Ki-67 index ≥15%) patients had shorter recurrence-free (P = 0.003), progression-free (P = 0.002), and cancer-specific (P = 0.003) survival. However, no statistically significant relationship was found between profilin 1 expression and clinicopathologic features and prognosis. CONCLUSIONS: Ki-67 is a highly predictive biomarker for recurrence-free, progression-free, and cancer-specific survival in pT1 bladder cancer patients, in whom prediction of recurrence and progression are difficult. Ki-67 expression can be safely combined with other prognostic factors. However, in pT1 bladder cancer patients, no significant relationship was found between profilin 1 expression and tumor characteristics or prognostic parameters.

Predictive risk factors of urinary tract infection following flexible ureteroscopic lithotripsy.

OBJECTIVES: The goal of current study was to evaluate prevalence of postoperative urinary tract infections (UTI) following flexible ureteroscopy (f-URS) and to determine predictive factors for those UTIs. METHODS: A total of 420 patients with urolithiasis that underwent f-URS between August 2018 and August 2019 were enrolled in the study. Peri-operative characteristics of patients with and without postoperative UTIs were compared using univariate analyses. Predictive factors for UTIs following f-URS were determined using multivariate logistic regression analysis. RESULTS: Forty-one (9.8%) out of 420 patients had postoperative urinary infection after f-URS and those patients were classified as group 1. Group 2 consisted of 379 patients that did not develop postoperative UTIs. The percentage of female gender was 58.5% vs 42% in groups 1 and 2, respectively (p=0.042). The preoperative UTI history rate was 51.2% vs 20.8% (p<0.001) and preoperative double J stent (DJS) insertion rate 39% vs 17.7% in groups 1 and 2, respectively (p=0.001). Univariate regression analyses showed that the female gender (OR=1.98), history of UTI (OR=3.99), and preoperative DJS insertion (OR=2.98) significantly increased the possibility of postoperative UTI (p<0.05). Multivariate regression analyses revealed that history of UTI (OR=3.41, 95%CI:1.73-6.72, p<0.001) and preoperative DJS insertion (OR=2.30, 95%CI:1.13-4.68, p=0.021) were independent risk factors for infectious complications following f-URS. If both factors are present, the probability of infection is 55.2%. CONCLUSIONS: Even if f-URS is considered a safe procedure, the risk of postoperative infectious complications is far from negligible. We found that the presence of UTI history and preoperative DJS were independent risk factors for UTI after f-URS.

OBJETIVOS: El objetivo del presente estudio fue evaluar la prevalencia de las infecciones del tracto urinario (UTI) postoperatorias después de la ureteroscopia flexible (f-URS) y determinar los factores predictivos de esas infecciones. MÉTODOS: Se inscribieron en el estudio un total de420 pacientes con urolitiasis que se sometieron a f-URSentre agosto de 2018 y agosto de 2019. Las característicasperioperatorias de los pacientes con y sin ITUUTI postoperatorias se compararon mediante análisisunivariados. Los factores predictivos de las infeccionesurinarias después de f-URS se determinaron mediante unanálisis de regresión logística multivariante. RESULTADOS: Cuarenta y uno (9,8%) de 420 pacientes tuvieron infección urinaria postoperatoria después de f-URS y esos pacientes se clasificaron como grupo 1. El grupo 2 consistió en 379 pacientes que no desarrollaron UTI postoperatorias. El porcentaje de sexo femenino fue del 58,5% frente al 42% en los grupos 1 y 2, respectivamente (p=0,042). La tasa de antecedentes de UTI preoperatoria fue del 51,2% frente al 20,8% (p<0,001) y la tasa de inserción preoperatoria de un stent doble J (DJS) del 39% frente al 17,7% en los grupos 1 y 2, respectivamente (p=0,001). Los análisis de regresión univariante mostraron que el sexo femenino (OR=1,98), los antecedentes de UTI (OR=3,99) y la inserción preoperatoria de DJS (OR=2,98) aumentaron significativamente la posibilidad de UTI postoperatoria (p<0,05). Los análisis de regresión multivariante revelaron que los antecedentes de UTI (OR=3,41, IC del 95%: 1,73­6,72, p<0,001) y la inserción preoperatoria de DJS (OR=2,30, IC del 95%: 1,13­4,68, p=0,021) eran factores de riesgo independientes para las complicaciones infecciosas después de f-URS. Si ambos factores están presentes, la probabilidad de infección es del 55,2%. CONCLUSIONES: Incluso si la f-URS se considera un procedimiento seguro, el riesgo de complicaciones infecciosas postoperatorias está lejos de ser insignificante. Encontramos que la presencia de antecedentes de UTI y la DJS preoperatoria eran factores de riesgo independientes de UTI después de f-URS.

Factores de riesgo predictivos de infección del tracto urinario después de la litotricia ureteroscópica flexible / Predictive risk factors for urinary tract infection after flexible ureteroscopic lithotripsy

Objetivos: El objetivo del presente estudio fue evaluar la prevalencia de las infecciones deltracto urinario (UTI) postoperatorias después de la ureteroscopia flexible (f-URS) y determinar los factores predictivos de esas infecciones. Métodos: Se inscribieron en el estudio un total de 420 pacientes con urolitiasis que se sometieron a f-URS entre agosto de 2018 y agosto de 2019. Las características perioperatorias de los pacientes con y sin ITUUTI postoperatorias se compararon mediante análisis univariados. Los factores predictivos de las infecciones urinarias después de f-URS se determinaron mediante un análisis de regresión logística multivariante. Resultados: Cuarenta y uno (9,8%) de 420 pacientes tuvieron infección urinaria postoperatoria despuésde f-URS y esos pacientes se clasificaron como grupo 1. El grupo 2 consistió en 379 pacientes que no desarrollaron UTI postoperatorias. El porcentaje de sexofemenino fue del 58,5% frente al 42% en los grupos 1 y 2, respectivamente (p=0,042). La tasa de antecedentes de UTI preoperatoria fue del 51,2% frente al 20,8% (p<0,001) y la tasa de inserción preoperatoria de un stent doble J (DJS) del 39% frente al 17,7% en los grupos 1 y 2, respectivamente (p=0,001). Los análisis deregresión univariante mostraron que el sexo femenino (OR=1,98), los antecedentes de UTI (OR=3,99) y la inserción preoperatoria de DJS (OR=2,98) aumentaron significativamente la posibilidad de UTI postoperatoria (p<0,05). Los análisis de regresión multivariante revelaron que los antecedentes de UTI (OR=3,41, IC del95%: 1,73–6,72, p<0,001) y la inserción preoperatoria de DJS (OR=2,30, IC del 95%: 1,13–4,68,p=0,021) eran factores de riesgo independientes para las complicaciones infecciosas después de f-URS. Si ambos factores están presentes, la probabilidad de infección es del 55,2%.(AU)

Objectives: The goal of current study was to evaluate prevalence of postoperative urinary tract infections (UTI) following flexible ureteroscopy (f-URS) and to determine predictive factors for those UTIs. Methods: A total of 420 patients with urolithiasis that underwent f-URS between August 2018 and August 2019 were enrolled in the study. Peri-operative characteristics of patients with and without postoperative UTIs were compared using univariate analyses. Predictive factors for UTIs following f-URS were determined using multivariate logistic regression analysis. Results: Forty-one (9.8%) out of 420 patients had postoperative urinary infection after f-URS and those patients were classified as group 1. Group 2 consisted of 379 patients that did not develop postoperative UTIs. The percentage of female gender was 58.5% vs 42% in groups 1 and 2, respectively (p=0.042). The preoperative UTI history rate was 51.2% vs 20.8% (p<0.001)and preoperative double J stent (DJS) insertion rate 39% vs 17.7% in groups 1 and 2, respectively (p=0.001). Univariate regression analyses showed that the female gender (OR=1.98), history of UTI (OR=3.99), and preoperative DJS insertion (OR=2.98) significantly increased the possibility of postoperative UTI (p<0.05).Multivariate regression analyses revealed that history of UTI (OR=3.41, 95%CI:1.73–6.72, p<0.001) and preoperative DJS insertion (OR=2.30, 95%CI:1.13–4.68,p=0.021) were independent risk factors for infectious complications following f-URS. If both factors are present, the probability of infection is 55.2%.Conclusions: Even if f-URS is considered a safe procedure, the risk of postoperative infectious complications is far from negligible. We found that the presence of UTI history and preoperative DJS were independent risk factors for UTI after f-URS.(AU)

The effect of ideal urine culture time on urinary infections after flexible ureteroscopy: A match-pair case-control study.

AIMS: To investigate the effect of the ideal period (Δ-day), which is a period between the sterile urine culture and initiation of flexible ureteroscopy (f-URS), on postoperative urinary tract infections (UTI) in our tertiary referral centre. METHODS: After obtaining the approval of the local ethics committee, retrospective data were collected for all f-URS procedures performed between January 2017 and March 2019. Patients that developed UTI were matched in 1:1 proportion with patients that did not develop UTI based on their demographic and stone characteristics. The group of patients with postoperative UTI was compared with the control group. RESULTS: A total of 916 f-URS cases that had all required data were analysed. Sixty-eight patients with postoperative UTI were determined and a total of 136 patients were included in the study after match-pair. We found that if the Δ-day is longer than 2 weeks, the possibility of postoperative urinary infection rates increases with statistical significance (P = .006). According to our subgroup analysis, postoperative UTI was more common if the Δ-day >14 days. ROC curve analysis provided a 14.5-day period as a cut-off value of Δ-day for postoperative UTI. CONCLUSIONS: The present study is the first to examine the impact of the Δ-day for f-URS on postoperative UTIs. In brief, prolonging the Δ-day, especially if Δ-day >14 days, leads to an increase in the rates of postoperative UTI. We conclude that it is preferred to either perform the f-URS in the early period after the urine culture analysis or doing the urine culture analysis shortly before the surgery.

The clinical impact of androgen deprivation therapy on SARS-CoV-2 infection rates and disease severity.

OBJECTIVE: The protective effect of androgen deprivation therapy (ADT) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel hypothesis. ADT may protect patients with prostate cancer through the inhibition of androgen receptor-dependent transmembrane serine protease type 2. We analyzed the role of ADT on SARS-CoV-2 infection risk and disease severity. MATERIAL AND METHODS: Between August 2020 and June 2021, patients with prostate cancer were included in our study. Patients were divided into two groups as men receiving ADT or not. Patients' characteristics such as prostate cancer grade and stage, comorbidities, SARS-CoV-2 infection status, and infection severity were assessed. SARS-CoV-2-infected close relatives and patients' compliance with the precautions against SARSCoV- 2 were also analyzed. RESULTS: A total of 365 patients, 138 (37.8%) with ADT and 227 (62.2%) without ADT, were included in our analysis. Patients with ADT were older (71.8 vs 66.9 years, P » .001) and had a higher rate of chronic obstructive pulmonary disease (11.6% vs 5.7%, P » .044). Patients receiving ADT were more often locally advanced and metastatic (80.4% vs 32.6%, P » .001). SARS-CoV-2 infection rates were statistically similar between patients who received and did not receive ADT (9.4% vs 13.2%, P » .275, respectively). There was no significant difference between two groups in terms of hospitalization rates (2.9% vs 0.9%, P » .205). In multivariate analysis, the presence of SARS-CoV-2-infected close relatives and precautions score were only independent predictors for both risk of SARS-CoV-2 infection and infection severity. CONCLUSION: We could not find any effect of ADT on risk and severity of SARS-CoV-2 infection. SARSCoV- 2 infection and hospitalization rates were similar between patients with and without ADT.