Dose-dependant preventive effect of a herbal compound on crystal formation in rat model.

INTRODUCTION: To analyze the dose-dependent preventive effect of a plant-based herbal product on the new crystal formation in a rat model. MATERIALS AND METHODS: A total of 42 rats were divided into 7 groups and zinc discs were placed into the bladder of rats to provide a nidus for the development of new crystal formation: Group 1: control, Group 2: 0.75 percent ethylene glycol (EG); Group 3: 0.75 percent EG plus 0.051 ml of the compound; Group 4: 0.75 percent EG plus 0.179 ml of the compound; Group 5: 0.75 percent EG plus 0.217 ml of the compound; Group 6: 0.75 percent EG plus 0.255 ml of the compound; Group 7 0.75 percent EG plus 0.332 of the compound). The analysis and comparison focused on the disc weights, changes in urinary oxalate and calcium levels, urinary pH, and the histopathologic evaluation of the inflammatory changes in the bladder after 14 days. RESULTS: According to the evaluation of discs placed in the bladders of the animals, animals receiving the herbal compound on a dose-dependent basis showed a limited increase in the disc weights values after 14 days, despite a considerable increase in animals receiving EG alone (p = 0.001). Further evaluation of the increase in disc weights on a dose-dependent basis in different subgroups (from Groups 3 to 7) demonstrated that the limitation of crystal deposition began to be more prominent as the dose of herbal compound increased. This effect was more evident particularly in comparisons between group 7 and others, according to LSD multiple comparison tests (p = 0.001). As anticipated, there has been no discernible change in the weight of the discs in the control group. Although urinary calcium levels in animals of Groups 2, 6, and 7 were significantly higher than the other groups, we were not able to demonstrate a close correlation between urinary oxalate levels and the increasing dose levels. Even though mean urine pH levels were statistically considerably higher in Group 3, there was no statistically significant correlation between the oxalate and calcium levels between all groups, and no association was seen with the administration of herbal agents. The transitional epithelium between the three groups of animals' bladder samples did not exhibit any appreciable difference according to pathological analysis. CONCLUSIONS: In this animal model, the treatment of the compound was successful in lowering the amount of crystal deposition surrounding the zinc discs, most noticeably at a dosage of 0.332 ml, three times per day.

Is Medical Therapy for Distal Ureteral Stones Efficient? Tamsulosin versus Deflazacort: A Prospective Randomised Trial.

INTRODUCTION: To evaluate the efficacy of tamsulosin and deflazacort in the spontaneous expulsion of distal ureteral stones when applied in an independent or combined manner. METHODS: 134 patients with distal ureteral stones (4 - 10 mm) were included in tothe study. All patients were randomized into four groups: group 1 (n = 37) patients receiving tamsulosin (0.4 mg/day); group 2 (n = 26) patients receiving deflazacort (30 mg/day); group 3 (n = 37) patients receiving combined treatment (tamsulosin and deflazacort) with the same dosages; and group 4, control group cases (n = 34), receiving paracetamol on demand. Although deflazacort treatment was limited to 10 days due to the possible associated side effects, α-blocker and paracetamol lasted up to four weeks. Patients were followed up on a weekly basis and at the end of four weeks all groups were compared primarily with respect to the stone expulsion rates. RESULTS: No statistically significant difference was noted between all groups regarding the age, sex, or stone burden (p > 0.05). Spontaneous stone expulsion rates after 4 weeks were 64.8 %, 69.2 %, 75.7 %, and 26.4 % in group 1, 2, 3, and 4 respectively. Spontaneous passage rates were statistically higher in all treatment groups when compared with the control group. Despite the highest spontaneous stone expulsion rate noted in group 3; this difference was not statistically significant when compared with the group 1 and 2. No major side effect related to the medications was observed. CONCLUSIONS: Tamsulosin facilitated the spontaneous passage of distal ureteral stones < 10 mm in size in an effective manner particularly when applied in combination with an oral corticosteroid.

Influence of COVID-19 pandemic on sexuality: a cross-sectional study among couples in Turkey.

Coronavirus disease 2019 (COVID-19) pandemic has been continuing to affect the lives of all people globally. It has been shown that restrictions due to changes in lifestyles lead to mental health problems. This study aims to investigate the effect of COVID-19 pandemic on couples' sexuality. A total of 245 volunteers (148 men and 97 women) were enrolled in the study. Generalized Anxiety Disorder-7, Patient Health Questionnaire, Perceived Stress Scale were administered to screen anxiety and depression symptoms. International Index of Erectile Function (IIEF-15) and Female Sexual Function Index (FSFI) along with self-constructed sexual behavior questionnaire were administered to participants, in order to evaluate sexual functions and behavioral changes during the pandemic. Sexual function scores (IIEF erectile function domain and total FSFI) during pandemic (24.55 ± 5.79 and 24.87 ± 7.88, respectively) were lower compared to the prepandemic period (26.59 ± 4.51 and 26.02 ± 6.22, respectively) (p = 0.001 and p = 0.027, respectively). During pandemic compared to prepandemic period, the frequency of sexual intercourse decreased in men (p = 0.001) and women (p = 0.001) while sexual avoidance and solitary sexual approach behaviors (masturbation or watching sexual content videos, etc.) increased in men (p = 0.001) and women (p = 0.022). However, the couples that spent more time together during the pandemic reported better sexual function scores (men; p = 0.001, women; p = 0.006). Although this is the first study evaluating couples from Turkey with a convenience sample, further studies with a greater number may better elucidate the effects of this pandemic on sexuality.

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.

Machine Learning-Empowered FTIR Spectroscopy Serum Analysis Stratifies Healthy, Allergic, and SIT-Treated Mice and Humans.

The unabated global increase of allergic patients leads to an unmet need for rapid and inexpensive tools for the diagnosis of allergies and for monitoring the outcome of allergen-specific immunotherapy (SIT). In this proof-of-concept study, we investigated the potential of Fourier-Transform Infrared (FTIR) spectroscopy, a high-resolution and cost-efficient biophotonic method with high throughput capacities, to detect characteristic alterations in serum samples of healthy, allergic, and SIT-treated mice and humans. To this end, we used experimental models of ovalbumin (OVA)-induced allergic airway inflammation and allergen-specific tolerance induction in BALB/c mice. Serum collected before and at the end of the experiment was subjected to FTIR spectroscopy. As shown by our study, FTIR spectroscopy, combined with deep learning, can discriminate serum from healthy, allergic, and tolerized mice, which correlated with immunological data. Furthermore, to test the suitability of this biophotonic method for clinical diagnostics, serum samples from human patients were analyzed by FTIR spectroscopy. In line with the results from the mouse models, machine learning-assisted FTIR spectroscopy allowed to discriminate sera obtained from healthy, allergic, and SIT-treated humans, thereby demonstrating its potential for rapid diagnosis of allergy and clinical therapeutic monitoring of allergic patients.

Discrimination of grass pollen of different species by FTIR spectroscopy of individual pollen grains.

Fourier-transform infrared (FTIR) spectroscopy enables the chemical characterization and identification of pollen samples, leading to a wide range of applications, such as paleoecology and allergology. This is of particular interest in the identification of grass (Poaceae) species since they have pollen grains of very similar morphology. Unfortunately, the correct identification of FTIR microspectroscopy spectra of single pollen grains is hindered by strong spectral contributions from Mie scattering. Embedding of pollen samples in paraffin helps to retrieve infrared spectra without scattering artifacts. In this study, pollen samples from 10 different populations of five grass species (Anthoxanthum odoratum, Bromus inermis, Hordeum bulbosum, Lolium perenne, and Poa alpina) were embedded in paraffin, and their single grain spectra were obtained by FTIR microspectroscopy. Spectra were subjected to different preprocessing in order to suppress paraffin influence on spectral classification. It is shown that decomposition by non-negative matrix factorization (NMF) and extended multiplicative signal correction (EMSC) that utilizes a paraffin constituent spectrum, respectively, leads to good success rates for the classification of spectra with respect to species by a partial least square discriminant analysis (PLS-DA) model in full cross-validation for several species. PLS-DA, artificial neural network, and random forest classifiers were applied on the EMSC-corrected spectra using an independent validation to assign spectra from unknown populations to the species. Variation within and between species, together with the differences in classification results, is in agreement with the systematics within the Poaceae family. The results illustrate the great potential of FTIR microspectroscopy for automated classification and identification of grass pollen, possibly together with other, complementary methods for single pollen chemical characterization.

Efficacy and safety of fURS in stones larger than 20 mm: is it still the threshold?

INTRODUCTION: The aim of this article was to evaluate the safety and efficiency of flexible ureteroscopy (fURS) in the management of renal calculi larger than 20 mm. MATERIAL AND METHODS: A total of 92 cases with renal calculi were managed with fURS and divided into two groups depending on the size of the stones; <20 mm and >20 mm (Group 1 and Group 2, respectively). The groups were compared with respect to treatment-related parameters including success, complication rates, hospitalization period and need for auxiliary procedures with an emphasis on the rate of infections. Success rates were also compared in each group according to stone location. RESULTS: Overall success rates after 3 months showed that stone-free rates in both groups were 84.1% (< 20 mm) and 58.33% (>20 mm) respectively (p = 0.008). The success rates of upper/mid pole (100% vs. 80%) and pelvis stones (83.3% vs. 75%) showed no statistically significant difference (p = 0.5, p = 0.51 respectively). Success rates for stones located in the lower pole were 75% vs. 14.28% respectively (p = 0.008). The rate of infectious complications was significantly higher in cases undergoing fURS for relatively larger stones (22.9%) as compared to smaller calculi (6.8%) (p = 0.032). No complications were recorded in Group 1, while 2 cases in Group 2 (4.1%) developed ureteral stricture. CONCLUSIONS: Despite the relatively low stone-free rates in lower pole stones, our current results indicate that fURS can be an effective and safe treatment alternative to PNL in larger renal stones (>20 mm) located in the pelvis and in the upper part of the calyceal system of the involved kidney.

Comparison of metabolic adaptation and biofilm formation of Actinobacillus pleuropneumoniae field isolates from the upper and lower respiratory tract of swine with respiratory disease.

Most outbreaks of disease due to infection with Actinobacillus (A.) pleuropneumoniae are caused by pigs already pre-colonised in tonsillar tissue, where the pathogen is protected from exposure to antibiotic substances administered for treatment. As it has been shown recently under experimental conditions, A. pleuropneumoniae displays host tissue-specific metabolic adaptation. In this study, pairs of A. pleuropneumoniae field isolates were recovered from lung as well as from tonsillar and nasal tissue from 20 pigs suffering from acute clinical signs of pleuropneumonia and showing characteristic pathological lung alterations. Metabolic adaptation to the porcine lower and upper respiratory tract of 32 A. pleuropneumoniae serotype 2 field isolates was examined using Fourier transform infrared (FTIR) spectroscopy as a high resolution metabolic fingerprinting method. All strains showed metabolic adaptations to organ tissue reflected by hierarchical cluster analysis of FTIR spectra similar to those previously observed under experimental conditions. Notably, differences in antimicrobial resistance patterns and minimal inhibitory concentrations of isolates from different tissues in the same animal, but not in biofilm production capability in a microtiter plate assay were found. Overall, biofilm formation was observed for 71 % of the isolates, confirming that A. pleuropneumoniae field isolates are generally able to form biofilms, although rather in a serotype-specific than in an organ-specific manner. A. pleuropneumoniae serotype 6 isolates formed significantly more biofilm than the other serotypes. Furthermore, biofilm production was negatively correlated to the lung lesion scores and tonsillar isolates tended to be more susceptible to antimicrobial substances with high bioavailability than lung isolates.

Safety and Efficacy of RIRS in Geriatric Patients: A Comparative Evaluation on an Age Based Manner.

PURPOSE: In this retrospective study, we aimed to comparatively evaluate the efficacy and safety of RIRS procedure on an age-based manner in patients younger and above 65 years. MATERIALS AND METHODS: A total of 165 patients undergoing RIRS procedure for renal stones were divided into two groups on an age-based manner namely; Group 1 (n=122) patients aging < 65 years and Group 2 (n=43) patients aging above 65 years. Demographic and clinical data regarding the stone free rates, complication rates and need for secondary procedures were retrospectively evaluated. RESULTS: Of all the patients undergoing RIRS for kidney stones, 122 were below the age of 65 (73.9%) and 43 were above the age of 65 (26.1%). Mean age value for the patients aging more than 65 years was 74.16 ± 5.03 years and in addition to higher percentage of comorbidities, serum creatinine levels as well as ASA scores were also higher in this group when compared with younger counterparts. Although there was no statistically significant difference with respect to the operative duration, stone-free rates (SFR) and hospitalization period between the two groups, both complication rates and the need for additional interventions were higher in the older patient group (p = 0.038; p = 0.032). All complications noted in the both groups were minor (Grade I) complications according to the Clavien classification system. CONCLUSION: RIRS procedure can be applied as an effective and safe treatment alternative for the minimal invasive management of renal stones in relatively older patients (> 65 years) with similar hospitalization as well as stone free rates noted in the younger patients. No procedure related severe complication was noted in these cases.

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.

Detection and Identification of Bacillus cereus, Bacillus cytotoxicus, Bacillus thuringiensis, Bacillus mycoides and Bacillus weihenstephanensis via Machine Learning Based FTIR Spectroscopy.

The Bacillus cereus group comprises genetical closely related species with variable toxigenic characteristics. However, detection and differentiation of the B. cereus group species in routine diagnostics can be difficult, expensive and laborious since current species designation is linked to specific phenotypic characteristic or the presence of species-specific genes. Especially the differentiation of Bacillus cereus and Bacillus thuringiensis, the identification of psychrotolerant Bacillus mycoides and Bacillus weihenstephanensis, as well as the identification of emetic B. cereus and Bacillus cytotoxicus, which are both producing highly potent toxins, is of high importance in food microbiology. Thus, we investigated the use of a machine learning approach, based on artificial neural network (ANN) assisted Fourier transform infrared (FTIR) spectroscopy, for discrimination of B. cereus group members. The deep learning tool box of Matlab was employed to construct a one-level ANN, allowing the discrimination of the aforementioned B. cereus group members. This model resulted in 100% correct identification for the training set and 99.5% correct identification overall. The established ANN was applied to investigate the composition of B. cereus group members in soil, as a natural habitat of B. cereus, and in food samples originating from foodborne outbreaks. These analyses revealed a high complexity of B. cereus group populations, not only in soil samples but also in the samples from the foodborne outbreaks, highlighting the importance of taking multiple isolates from samples implicated in food poisonings. Notable, in contrast to the soil samples, no bacteria belonging to the psychrotolerant B. cereus group members were detected in the food samples linked to foodborne outbreaks, while the overall abundancy of B. thuringiensis did not significantly differ between the sample categories. None of the isolates was classified as B. cytotoxicus, fostering the hypothesis that the latter species is linked to very specific ecological niches. Overall, our work shows that machine learning assisted (FTIR) spectroscopy is suitable for identification of B. cereus group members in routine diagnostics and outbreak investigations. In addition, it is a promising tool to explore the natural habitats of B. cereus group, such as soil.

Combining Chemical Information From Grass Pollen in Multimodal Characterization.

The analysis of pollen chemical composition is important to many fields, including agriculture, plant physiology, ecology, allergology, and climate studies. Here, the potential of a combination of different spectroscopic and spectrometric methods regarding the characterization of small biochemical differences between pollen samples was evaluated using multivariate statistical approaches. Pollen samples, collected from three populations of the grass Poa alpina, were analyzed using Fourier-transform infrared (FTIR) spectroscopy, Raman spectroscopy, surface enhanced Raman scattering (SERS), and matrix assisted laser desorption/ionization mass spectrometry (MALDI-TOF MS). The variation in the sample set can be described in a hierarchical framework comprising three populations of the same grass species and four different growth conditions of the parent plants for each of the populations. Therefore, the data set can work here as a model system to evaluate the classification and characterization ability of the different spectroscopic and spectrometric methods. ANOVA Simultaneous Component Analysis (ASCA) was applied to achieve a separation of different sources of variance in the complex sample set. Since the chosen methods and sample preparations probe different parts and/or molecular constituents of the pollen grains, complementary information about the chemical composition of the pollen can be obtained. By using consensus principal component analysis (CPCA), data from the different methods are linked together. This enables an investigation of the underlying global information, since complementary chemical data are combined. The molecular information from four spectroscopies was combined with phenotypical information gathered from the parent plants, thereby helping to potentially link pollen chemistry to other biotic and abiotic parameters.

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) shows adaptation of grass pollen composition.

MALDI time-of-flight mass spectrometry (MALDI-TOF MS) has become a widely used tool for the classification of biological samples. The complex chemical composition of pollen grains leads to highly specific, fingerprint-like mass spectra, with respect to the pollen species. Beyond the species-specific composition, the variances in pollen chemistry can be hierarchically structured, including the level of different populations, of environmental conditions or different genotypes. We demonstrate here the sensitivity of MALDI-TOF MS regarding the adaption of the chemical composition of three Poaceae (grass) pollen for different populations of parent plants by analyzing the mass spectra with partial least squares discriminant analysis (PLS-DA) and principal component analysis (PCA). Thereby, variances in species, population and specific growth conditions of the plants were observed simultaneously. In particular, the chemical pattern revealed by the MALDI spectra enabled discrimination of the different populations of one species. Specifically, the role of environmental changes and their effect on the pollen chemistry of three different grass species is discussed. Analysis of the group formation within the respective populations showed a varying influence of plant genotype on the classification, depending on the species, and permits conclusions regarding the respective rigidity or plasticity towards environmental changes.

Enterotoxin Production of Bacillus thuringiensis Isolates From Biopesticides, Foods, and Outbreaks.

While the relevance of Bacillus (B.) cereus as a major cause of gastroenteritis is undisputed, the role of the closely related B. thuringiensis in foodborne disease is unclear. B. thuringiensis strains frequently harbor enterotoxin genes. However, the organism has only very rarely been associated with foodborne outbreaks, possibly due to the fact that during outbreak investigations, B. cereus is routinely not differentiated from B. thuringiensis. A recent EFSA scientific opinion stresses the urgent need for further data allowing for improved risk assessment, in particular as B. thuringiensis is a commonly used biopesticide. Therefore, the aim of this study was to gain further insights into the hazardous potential of B. thuringiensis. To this end, 39 B. thuringiensis isolates obtained from commercially used biopesticides, various food sources, as well as from foodborne outbreaks were characterized by panC typing, panC-based SplitsTree analysis, toxin gene profiling, FTIR spectroscopic analysis, a cytotoxicity assay screening for enterotoxic activity, and a sphingomyelinase assay. The majority of the tested B. thuringiensis isolates exhibited low (23%, n = 9) or mid level enterotoxicity (74%, n = 29), and produced either no (59%, n = 23) or low levels (33%, n = 13) of sphingomyelinase, which is reported to act synergistically with enterotoxins Nhe and Hbl. One strain isolated from rosemary was however classified as highly enterotoxic surpassing the cytotoxic activity of the high-level reference strain by a factor of 1.5. This strain also produced vast amounts of sphingomyelinase. Combining all results obtained in this study into a fingerprint pattern, several enterotoxic biopesticide strains were indistinguishable from those of isolates from foods or collected in association with outbreaks. Our study shows that many B. thuringiensis biopesticide strains exhibit mid-level cytotoxicity in a Vero cell assay and that some of these strains cannot be differentiated from isolates collected from foods or in association with outbreaks. Thus, we demonstrate that the use of B. thuringiensis strains as biopesticides can represent a food safety risk, underpinning the importance of assessing the hazardous potential of each strain and formulation used.

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 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.

Complications and prostate cancer diagnosis rate of TRUS prostate biopsies using 16 and 18G needles by Clavien scoring.

AIM: We aimed to compare the 18 and 16-Gauge (G) needles used in transrectal ultrasonography (TRUS)-guided needle biopsy for cancer detection rates and complications using the Clavien Scoring System. MATERIALS AND METHODS: The 80 patients who were included in the study were randomized and divided into two groups. Group 1 (n = 36) had a TRUS-guided prostate biopsy with an 18G needle and Group 2 had a 16G needle (n = 44). The hematuria, bleeding assessment, and infection events were evaluated on a daily basis. These complications were graded according to the Clavien Scoring. RESULTS: In Group 1, only five (13%) patients were diagnosed with prostate cancer, and three patients were reported to have atypical small acinar proliferation (ASAP). In Group 2, 16 (36%) patients were diagnosed with prostate cancer and one patient was reported to have ASAP. The difference in the prostate cancer detection rate between the groups was statistically significant. According to the Clavien grading system, the complications were at the Grade 1 level in 25 people in Group 1 in 29 people in Group 2. Grade 2 level complications were not observed in either group. While one person was Grade 3 in Group 1, two people in Group 2 had this rate. There were no significant differences between the groups. CONCLUSIONS: We found that cancer detection rate increased by increasing the thickness of the needle used in TRUS-guided prostate biopsy without any increase in the complications.

What is new in non-muscle-invasive bladder cancer in 2016?

Approximately 75% of bladder cancers are non-muscle-invasive bladder cancer (NMIBC), and 50% of NMIBC patients who are treated with transurethral resection (TUR) have a recurrence of the disease and 5-25% of these patients progressed to muscle-invasive disease after repeated recurrences. NMIBC patients receive various treatments aimed at reducing disease recurrence and progression. Although the recurrence rate of disease remains above target, thus increasing treatment cost, the true rate of recurrence after the primary surgery is controversial. Recurrences can be categorized as either true recurrence due to aggressive tumor biology and implantation of floating cancer cells or false recurrence such as small, flat, or carcinoma in situ lesions overlooked in the primary procedure. Here we discuss new diagnostic methods and treatment options to improve outcomes and reduce recurrence rates in NMIBC.

Efficacy of using Zaontz urethral stent in hypospadias repair by the Face, Legs, Activity, Cry, Consolability (FLACC) scale: A prospective study.

INTRODUCTION: The developments in hypospadias surgical techniques and materials are intended to improve surgery outcomes and patient comfort. The aim of this study is to determine the effect of the Zaontz urethral stent (ZUS) (Cook Medical) on patient comfort and surgical success rates in children undergoing hypospadias surgery. METHODS: A feeding tube was used to repair 46 cases of primary distal hypospadias, and ZUS (6F, 8F, and 10F in diameter) was used to repair to 31 cases of primary distal hypospadias between December 2009 and June 2011 in our clinic. ZUS was compared with the feeding tube in terms of surgical success rates and patient comfort in assessments made during postoperative periods. RESULTS: The patients with ZUS were followed with a stent for seven days postoperatively, as were the patients with the feeding tube. There was no statistical difference between the two groups in terms of fistula formation (p>0.05). Patient comfort was evaluated by the Face, Legs, Activity, Cry, Consolability (FLACC) scale on the first and third postoperative days, and a statistically significant difference was observed in favour of ZUS on the third postoperative day (p<0.05). CONCLUSIONS: Compared with a feeding tube in hypospadias repair, ZUS does not make any contribution to the urinary fistula rates. However, ZUS may have an advantage in terms of patient comfort in the postoperative followup. On the other hand, the small number of patients and the high price of the ZUS were the most important limitations. Prospective, randomized trials are needed to assess efficacy and cost.

The modified ultra-mini percutaneous nephrolithotomy technique and comparison with standard nephrolithotomy: a randomized prospective study.

To compare the success and complications of ultra-mini percutaneous nephrolithotomy (UPNL) and standard percutaneous nephrolithotomy (SPNL) techniques. We prospectively analyzed 50 patients who underwent SPNL, and 47 patients who underwent UPNL. The patients with a stone size equal to or smaller than 25 mm and we used flipping a coin as the randomization technique. The mean stone size was 20.9 ± 3.6 mm in SPNL, and 20.3 ± 3.0 mm in ultra-mini PNL groups. Stone free rates were 88 % (44/50 patients) and 89.3 % (42/47 patients) in SPNL and UPNL groups, respectively, without any significant difference in between (p = 0.33). No major complications were seen in the UPNL group. PNL has been modified into micro PNL and UPNL parallel to the technological advances to decrease the complications of PNL. When performed as we do UPNL may be an alternative method to SPNL without any additional smaller-calibred nephroscope and with a similar high success rate.