Is there an association between a high monocyte/high-density lipoprotein cholesterol ratio and recurrence of urethral stricture after internal urethrotomy?

INTRODUCTION: Internal urethrotomy (IU) has been the most commonly used procedure for the treatment of urethral strictures (US) since it was described by Scahse in 1974. Although simple to perform and associated with a short recovery time, the main disadvantage is the high recurrence rate of stenosis. At present, there are no markers available for the prediction of recurrence after IU. The aim of this study was to evaluate the correlation between MHR and recurrence rates. METHODS: The data of a total of 250 male patients who underwent IU for the first time for bulbar urethral stricture less than 2cm in our hospital between January 2011 and January 2019 were retrospectively analysed. The MHR was calculated as the ratio of monocytes to HDL-C. RESULTS: In all, 78 patients experienced a recurrence while the remaining 177 did not. The stricture recurrence rate was recorded as 31.2% at the 3-year follow-up. There was a statistically significant difference in stricture length and MHR (P=0.015 and 0.001 respectively). MHR was high in the recurrent group. As a result of the Chi-square test, the positive predictive values (PPV) and negative predictive values (NPV) were 65.3% and 89.7%, respectively. ROC analysis was used to determine the optimal cut-off value. The cut-off value was found to be 1.72. CONCLUSION: In our opinion, a high MHR may indicate the presence of immune inflammation and it can be used as a prognostic factor for stricture recurrence after IU.

Efficacy of Aspiration-Assisted Ureteral Access Sheath (ClearPETRA) in Retrograde Intrarenal Surgery.

Backgrounds: In the renal intrarenal stone surgery (RIRS) procedure, ureteral access sheath (UAS) is still used in the majority of surgeries to both protect the flexible ureteroscope (FURS) and reduce intrarenal pressure. ClearPETRA is a new UAS that has an integrated aspiration port. We aimed to evaluate the clinical outcomes and effectiveness of Aspiration-Assisted UAS (ClearPETRA) in the RIRS procedure. Methods: One thousand six hundred twenty patients who underwent RIRS between January 2021 and January 2024 were evaluated retrospectively and 512 patients were included in the study. According to stone size, patients with stones less than 2 cm and those with stones between 2 and 3 cm were analyzed separately. Patient's demographic data, stone size, body mass index, Extracoporeal Shockwave Lithotripsy (ESWL) history, stone side, stone density (Hounsfield Unit), operation time, stone-free rate (SFR), and the number of patients with sepsis were recorded. SFR was evaluated with kidney urinary bladder 3 months after surgery for opaque calculi. Nonopaque calculi patients were evaluated with noncontrast computed tomography 3 months after surgery. In the postoperative evaluation, patients with stones less than 4 mm were evaluated as SFR. P value of <0.01 was considered statistically significant. Results: Patient's demographic data, stone characteristics, and history of ESWL were similar in the ClearPETRA and UAS groups (P > .05). A total of 328 patients who underwent RIRS for stones less than 2 cm were included (80 ClearPETRA, 248 UAS). Length of hospital stay, operation time, SFR, secondary intervention, or postoperative sepsis (P ≥ .01) were similar in both groups. The incidence of postoperative fever was statistically significantly lower in the ClearPETRA group (P = .006). A total of 184 patients who underwent RIRS for stones between 2 and 3 cm were included (42 ClearPETRA, 142 UAS). In the ClearPETRA group, operation time was statistically significantly shorter (P = .002), SFR was statistically significantly higher (P = .003), and the number of fever and sepsis were statistically significantly less (P = .003 and 0.002, respectively). Conclusion: We found that ClearPETRA reduces the likelihood of postoperative fever after RIRS surgeries. Moreover, we can say that the use of ClearPETRA in RIRS, especially for stones larger than 2 cm, reduces the operation time, increases the SFR, and also reduces sepsis rates.

Systemic Inflammatory Index: A Promising Non-Invasive Marker for the Prediction of Response to Neoadjuvant Chemotherapy prior to Cystectomy.

INTRODUCTION: The main challenge to the optimal use of neoadjuvant chemotherapy (NAC) is the difficulty in selecting patients who may or may not benefit from NAC. Our aim in this study was to investigate whether the Systemic Inflammatory Index (SII) predicts response to chemotherapy in patients who receive NAC prior to cystectomy. METHODS: We retrospectively analysed the data of patients who underwent NAC followed by cystectomy at our institution between January 2010 and September 2015 and whose 5-year follow-up was completed. All patients who underwent diagnostic biopsy with complete transurethral resection of bladder tumour at our hospital and whose pathology result was muscle-invasive transitional cell carcinoma were included in the study. At least 3 courses of gemcitabine/cisplatin NAC were given to all patients. A pathological response was defined as a reduction in cystectomy to a lower pathological stage after NAC. RESULTS: The SII was 320.8 ± 51 in the responders and 388.28 ± 50 in the non-responders. SII optimal cut-off of 350 was determined. The sensitivity and specificity of SII in predicting response were found to be 80% and 83%, respectively. Low SII (<350) was found to be a significant predictor of response compared with the other factors on multivariate analysis. The mean overall survival time was 55.4 months in patients with a low SII value and 40.3 months in the high SII group. CONCLUSION: SII, together with known clinicopathological factors and newer genetic and molecular markers, can be used to select patients for NAC.

Detection and classification of COVID-19 by using faster R-CNN and mask R-CNN on CT images.

The coronavirus (COVID-19) pandemic has a devastating impact on people's daily lives and healthcare systems. The rapid spread of this virus should be stopped by early detection of infected patients through efficient screening. Artificial intelligence techniques are used for accurate disease detection in computed tomography (CT) images. This article aims to develop a process that can accurately diagnose COVID-19 using deep learning techniques on CT images. Using CT images collected from Yozgat Bozok University, the presented method begins with the creation of an original dataset, which includes 4000 CT images. The faster R-CNN and mask R-CNN methods are presented for this purpose in order to train and test the dataset to categorize patients with COVID-19 and pneumonia infections. In this study, the results are compared using VGG-16 for faster R-CNN model and ResNet-50 and ResNet-101 backbones for mask R-CNN. The faster R-CNN model used in the study has an accuracy rate of 93.86%, and the ROI (region of interest) classification loss is 0.061 per ROI. At the conclusion of the final training, the mask R-CNN model generates mAP (mean average precision) values for ResNet-50 and ResNet-101, respectively, of 97.72% and 95.65%. The results for five folds are obtained by applying the cross-validation to the methods used. With training, our model performs better than the industry standard baselines and can help with automated COVID-19 severity quantification in CT images.

The effect of an information video on preoperative anxiety level before percutaneous nephrolithotomy procedure: A prospective, randomized trial.

INTRODUCTION: We aimed to show the effect of patient information videos on preoperative anxiety before performing the percutaneous nephrolithotomy (PCNL ) for kidney stones. METHODS: This study was designed as a randomized, controlled trial with patients scheduled for PCNL operation for kidney stones. Demographic information, such as age, gender, and American Society of Anesthesiologists (ASA) score, were collected. State-Trait Anxiety Inventory (ST AI) was used to measure anxiety levels. Before informing the patients, anxiety levels were evaluated using the ST AI-state (pre-information ST AI-S) and ST AI-trait (ST AI-T). Patients were randomly divided into two groups: both groups received written and verbal information, while the "video" group was also shown a video of a PCNL procedure. The post-information anxiety levels of both groups were evaluated using ST AI-S (post-information). RESULTS: A total of 109 patients were included in the study and 50 patients were included in each group after nine patients were excluded. The participants in the two groups were similar in terms of gender distribution, mean age, and pre-information ST AI-S scores. Post-information ST AI-S scores were statistically significantly lower in the video group (p=0.02). There was no significant difference between post-information and pre-information ST AI-S scores in the no-video group (p=0.86), whereas a significant decrease was found in post-information ST AI-S scores in the video group (p<0.01). CONCLUSIONS: In addition to written and verbal information before PCNL operations, informative videos are an inexpensive, effective method to reduce preoperative anxiety levels. Video-based briefing may be routinely used in addition to preoperative verbal and written information.

Value of neutrophil-to-lymphocyte ratio in predicting surgical intervention for hydronephrosis during pregnancy.

BACKGROUND: We aimed to examine the hematological parameters of pregnant patients with ureteral stones that require intervention. METHODS: Medical data of patients presenting to urology department between October 2018 and December 2020 were retrospectively analyzed. Patients with flank pain associated with hydronephrosis were included in the study and divided into two groups according to whether an intervention was performed or not (Group-1, Group-2). Ureterorenoscopy (URS) or ureteral stent placement was performed as intervention. Demographic data, complete blood count (CBC), urine analysis, and ultrasonographic findings were collected. Gestational age (week), number of pregnancies, maternal age (years), Anteroposterior pelvis diameter (mm), VAS (Visual Analog Scale) (range 1-10) and mean platelet volume (MPV) were collected from the patient file. Inflammatory markers including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were computed. RESULTS: About 35 patients were included in Group-1 and 52 patients in Group-2. Ureterorenoscopy was performed in 21/35 (60%) patients, and ureteral stents were placed in 14/35 (40%) patients. None of the patients experienced complications. There was no statistical difference between these two groups in terms of maternal age, gestational age, number of pregnancies, pelvis diameter, PLR, and MPV. VAS and NLR were statistically higher in group-1 (p < 0.05). According to the Receiver operating characteristic curve analysis performed for the prediction of ureteral stone presence, the best cut-off point for the NLR 4.153 (sensitivity 80%, specificity 80.6%, area under curve (AUC): 0.824). CONCLUSIONS: We think that NLR can be used to determine the group that needs to be intervented due to ureteral stones in patients with symptomatic hydronephrosis during pregnancy.

Comparison of mini-PCNL and retrograde intrarenal surgery in the treatment of kidney stone over 50 years old patients.

Mini-Percutaneous Nephrolithotomy (M-PCNL) and Retrograde Intrarenal Surgery (RIRS) are commonly used methods in treatment of kidney stones. The aim of our study is to compare the efficacy and safety of M-PCNL and RIRS in kidney stone treatment over 50 years old patients. A total of 125 patients, 65 of whom had RIRS, and 60 of whom had M-PCNL, were included in the study. Age, gender, BMI (Body-Mass Index), ASA (American Society of Anesthesiology) scores of the patients; stone size, stone location, operation side, ESWL history, HU (Hounsfield Unit) values, hospital stay durations, SFR, complication rates according to Clavien modification system, postoperative hemoglobin loss, postoperative transfusion rates, and patients who needed a secondary operation were recorded. SFR values were calculated in the postoperative third and sixth months. The data between the two groups had similar characteristics in terms of age, gender, BMI, HU, stone size, operation side, stone location, ESWL history, operation time, postoperative transfusion rate, postoperative Clavien complications (p > 0.05). When the ASA categories were evaluated, the mean ASA scores, ASA I, and ASA II data had similar characteristics in both groups (p > 0.05). When the ASA 3 scores were evaluated, the number of ASA III patients in the RIRS group was statistically significantly higher (p < 0.05). When hospital stay duration and postoperative hemoglobin loss were examined, RIRS group was found to be advantageous (p < 0.05). Postoperative third month SFR and Postoperative sixth month values were statistically significantly higher in M-PCNL group (p < 0.05). M-PCNL and RIRS are methods that can be used safely and effectively over 50 years old patients in kidney stone surgery. M-PCNL has been found to be more advantageous in terms of SFR rates and as it requires less secondary intervention. RIRS is advantageous in terms of short hospital stay, postoperative hemoglobin loss, and applicability to patients who are not suitable for the prone position.

Application of S.T.O.N.E. Nephrolithometry Score for Prediction of Stone-Free Status and Complication Rates in Patients Who Underwent Percutaneous Nephrolitotomy for Renal Stone.

Background: Renal stone disease is a common disorder in urology practice. Kidney stone has various treatment methods such as extracorporeal shock wave lithotripsy, retrograde intrarenal surgery, and percutaneous nephrolithotomy (PCNL). In this study, we aimed to determine the value of S.T.O.N.E. nephrolithometry score, which is considered as a new scoring system for predicting residual stone rate and complications in patients undergoing PCNL due to renal calculi. Materials and Methods: A total of 120 patients >18 years old who underwent PCNL were evaluated prospectively. Five parameters available from preoperative noncontrast-enhanced computed tomography were measured: stone size (S), tract length (T), obstruction (O), number of involved calices (N), and essence or stone density (E) and then S.T.O.N.E. nephrolithometry score was calculated. The prediction of the stone-free rates and complication rates of this scoring was evaluated statistically. Results: When the age, gender, body mass index, comorbidities, and American Society of Anesthesiologists scores of the patients were evaluated according to the patients' postoperative stone-free status, no statistical difference was found between the groups. Patients had a stone-free rate of 78%. Patients' mean neuropilitometry score was calculated to be 7.75 S.T.O.N.E. nephrolithometry score statistically significant (P = .001) for prediction of stone-free status. S.T.O.N.E. nephrolithometry score was significantly correlated with operation time, estimated blood loss, duration of fluoroscopy, duration of hospital stay, and number of punctures. Complications were seen in 13 patients. Conclusions: S.T.O.N.E. nephrolithometry score can be used as an objective criterion for predicting the complexity of the PCNL process. In addition, this scoring system is expected to provide more objective preoperative counseling and can provide standardization in academic studies.

Self-Insertion of Newspaper into Bladder: An Unusual Case of Foreign Body.

Foreign bodies are most frequently observed in the bladder among the genitourinary organs. Many different foreign bodies such as needles, wires, Foley's catheter fragments, and magnetic balls have been observed in the bladder previously. In the present case, a 50-year male patient presented to the hospital with fever and acute urinary retention. Despite antibiotic therapy, the urinary tract infection did not regress, and the patient's suspicious statements were associated with the foreign body. Examination of the patient necessitated further enquiry upon the detection of newspaper pieces in the bladder. It was discovered that the patient had folded the newspaper in an attempt to commit suicide and pushed it into the bladder. Such a case has never been observed previously in the literature. An 8-cm rolled piece of newspaper was detected in the bladder using a cystoscope and was removed with open surgery. Key Words: Bladder, Foreign body, Newspaper.

A Combined Experimental and Modeling Study for Pellet-Fed Extrusion-Based Additive Manufacturing to Evaluate the Impact of the Melting Efficiency.

To improve the product quality of polymeric parts realized through extrusion-based additive manufacturing (EAM) utilizing pellets, a good control of the melting is required. In the present work, we demonstrate the strength of a previously developed melt removal using a drag framework to support such improvement. This model, downscaled from conventional extrusion, is successfully validated for pellet-based EAM-hence, micro-extrusion-employing three material types with different measured rheological behavior, i.e., acrylonitrile-butadiene-styrene (ABS), polylactic acid (PLA) and styrene-ethylene-butylene-styrene polymer (SEBS). The model's validation is made possible by conducting for the first time dedicated EAM screw-freezing experiments combined with appropriate image/data analysis and inputting rheological data. It is showcased that the (overall) processing temperature is crucial to enable similar melting efficiencies. The melting mechanism can vary with the material type. For ABS, an initially large contribution of viscous heat dissipation is observed, while for PLA and SEBS thermal conduction is always more relevant. It is highlighted based on scanning electron microscopy (SEM) analysis that upon properly tuning the finalization of the melting point within the envisaged melting zone, better final material properties are achieved. The model can be further used to find an optimal balance between processing time (e.g., by variation of the screw frequency) and material product performance (e.g., strength of the printed polymeric part).

Measurement of the facial nerve thickness and its correlation with freezing phenomenon and hypomimia in Parkinson's disease.

OBJECTIVE: Hypomimia is one of the diagnostic features in Parkinson's disease, and freezing blocks may also occur with the degenerative process. We investigated that the thickness of the cranial facial nerve that innervates facial expressions, and the relationship between bradymimia and freezing phenomena in these patients. METHODS: We included 70 patients and healthy participants in this cross-sectional study. Clinical characteristics, modified Hoehn and Yahr (mHY) stages, Unified Parkinson's Disease Rating Scale (UPDRS) scores and Freezing of Gait Questionnaire (FOG-Q) scores of Parkinson's patients were recorded. FOG-Q was scored between 1 and 4 points. The thickness of the facial nerve and its neighborhoods of numerically equal groups were measured radiologically in the internal acoustic channel (IAC) with magnetic resonance imaging of temporal lobe. Right and left facial nerve thicknesses were compared. RESULTS: The right facial nerve thicknesses of the patient and control groups were measured as 0.97 ± 0.12 mm and 1.20 ± 0.10 mm at the proximal level and 0.71 (0.69-0.81) mm and 1.21 (1.13-1.24) mm at the distal level, respectively (P < 0.001). Notably, the facial nerve was more atrophied on the right than on the left (P < 0.001). Facial nerve to IAC ratio (%) was significantly lower and cerebrospinal fluid thickness distance (%) measurement was significantly higher (P < 0.001). Also, the FOG-Q and facial nerve to IAC ratio were negatively correlated (P = 0.049, rho = -0.335). CONCLUSIONS: Our study provides new information about the facial nerve and its neighborhoods and clinical relationships in individuals with PD. In studies investigating hypomimia and FOG in Parkinson's, neuroimaging of the facial nerve can also be used. These results need to be proven with more comprehensive studies.

Success of extracorporeal shock wave lithotripsy based on CT texture analysis.

OBJECTIVE: The aims of the study were to evaluate whether computerised tomography texture analysis (CTTA) based on non-contrast computed tomography (NCCT) has predictive value for the success of extracorporeal-shockwave lithotripsy (ESWL) in upper urinary tract stones (UUTS). METHODS: This study included 156 of 356 patients undergoing ESWL for UUTS sized 0.5-2 cm from 2015 to 2019. Patients with congenital kidney anomalies, radiolucent stones, multiple stones, treated for upper urinary tract stones previously and lower pole stones were excluded from study. The number of ESWL sessions of the patients was as follows: 78 (50%) patients had 1 session, 30 (19.2%) patients had 2 sessions and 48 (30.8%) patients had >2 sessions. First- and second-order CTTA properties of patients' UUTS were evaluated using texture analysis software (LIFEx Software). Other clinical features such as Hounsfield Unit (HU), initial stone size, body-mass index (BMI) and skin to stone distance (SSD) was recorded. The patients were divided into two groups according to ESWL success. Cases with residual stones larger than 4 mm were considered failed cases. RESULTS: BMI, the standard deviation of HU, SSD, skewness, kurtosis, entropy and all second-order statistics were found to be statistically different between the two groups except for correlation (P < .05). Multivariate analysis showed longer SSD and four new parameters of CTTA (kurtosis, entropy, dissimilarity and energy by the distribution of pixel grey levels in the UUTS) to be significant predictors for unsuccessful ESWL outcomes. SSD and second-order CTTA properties (dissimilarity and energy) had an area under ROC curve of 0.802, 0.850 and 0.824 at a 95% confidence interval. ESWL success rate in all patients was 76.9%. CONCLUSION: CTTA can help select patients who will undergo ESWL for upper urinary tract stones. Thus, we can reduce treatment costs and ESWL complications by preventing unnecessary ESWL applications.

The efficacy and reliability of VI-RADS in determining candidates for repeated transurethral resection in patients with high-risk non-muscle invasive bladder cancer.

OBJECTIVE: Our study aims to evaluate the efficiency and reliability of Vesical Imaging Reporting Data System (VI-RADS) in prospectively identifying the patients to undergo RE-TURBT in the management of patients with high-risk non-muscle invasive Bladder Cancer(HR-NMIBC).The secondary objective was to evaluate the performance of the VI-RADS scoring system in differentiating between muscle-invasive bladder cancer (MIBC) and non-muscle invasive bladder cancer(NMIBC) prospectively. METHODS: The study included 330 patients who underwent transurethral resection of bladder tumour(TURBT) for Bladder Cancer (BC) in our clinic. All patients underwent multiparametric-magnetic resonance imaging (Mp-MRI) before the operation and VI-RADS scoring was administered. The cut-off value of VI-RADS was accepted as three and above. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for the differentiation between NMIBC and MIBC distinction in all patients. Receiver operating characteristic (ROC) analysis was performed to evaluate the performance of the VI-RADS scoring system. In the second phase of the study, patients with MIBC and low-risk NMIBC (LR-NMBIC) were excluded and 158 patients with HR-NMIBC were included, and their sensitivity, specificity, PPV and NPV values were measured. ROC analysis was performed. RESULTS: In all patients, sensitivity, specificity, PPV and NPV values of the VI-RADS scoring in the differentiation of MIBC and NMIBC were 91.3, 91.8, 81.7 and 96.3 respectively. The AUC value was 0.934 (95%CI: 0.903-0.964). Sensitivity, specificity, PPV and NPV values were found to be 87, 91.8, 74.1, 95.2 in the evaluation specifically made for patients with HR-NMIBC. The AUC value was 0.900 (95% CI:0.843-0.957). Inter-reader agreement was excellent (Ƙ = 0.90, 95% CI:0.71-0.95). CONCLUSIONS: The VI-RADS scoring system is an effective and reliable method in determining the patients who will undergo RE-TURBT and in differentiating MIBC and NMIBC.

The effect of COVID-19 on lower urinary tract symptoms in elderly men.

AIMS: The COVID-19 pandemic is the most important public health problem in 2020. Millions of people have been infected or died because of the outbreak. We know the common symptoms of the disease such as fever and cough. However, all symptoms and features of COVID-19 are still were not known. We aimed to evaluate the change in lower urinary tract symptoms (LUTS) after COVID-19 in men. METHODS: We prospectively assessed 94 patients with COVID-19 during hospitalisation. The patients were divided into two groups according to age, that being over and under age 50. IPSS scores of all patients were enrolled. Additionally, we compared the scores with pre-COVID-19 values. RESULTS: LUTS scores were found to be increased in elderly patients. Additionally, the severity of the disease did not correlate with LUTS scores. CONCLUSION: LUTS may be one of the symptoms of COVID-19 in some patients. Elderly patients with increased LUTS should be evaluated for COVID-19 when the reason unclear.

Influence of 3D-Calculated Parenchymal Volume Loss on Renal Function After Partial Nephrectomy.

Background: Our study aims to evaluate the influence of potential determinants of glomerular filtration rate (GFR) decrease after partial nephrectomy (PN), including renal parenchymal loss and other clinical, tumoral, and surgical factors. Materials and Methods: Eighty-six patients who had undergone PN and for whom preoperative and postoperative computerized tomography scans were available were selected. We calculated the preoperative total kidney volumes, tumor volumes, and postoperative total kidney volumes 1 year after surgery using a three-dimensional (3D) volume segmentation method. Factors that may be potential determinants of percent GFR decrease were also evaluated, including patient age, type of procedure (laparoscopic vs. open), comorbidity index, preoperative GFR, tumor size and volume, RENAL nephrometry score, warm ischemia time, and 3D calculated renal parenchymal loss. Clinical, surgical, and tumor parameters potentially associated with renal parenchymal loss were evaluated. Results: The mean age of the patients was 58 years, the mean tumor diameter was 3.6 cm, and the mean tumor volume was 11.7 cc. The mean percent of renal parenchymal loss was 22.3%, and the mean percent of GFR loss was 17.3%. The renal parenchymal loss was strongly associated with age (r = 0.702, P = .02), Charlson comorbidities index (r = 0.768, P < .001), and RENAL nephrometry score (r = 0.812, P < .001). In multivariate logistic regression analysis, older age, higher Charlson comorbidities index, higher percent renal parenchymal loss, and higher RENAL nephrometry score were independently associated with higher percent of GFR loss. Conclusion: Of all the factors analyzed, RENAL score and Charlson comorbidities index were the most accurate predictors of postoperative parenchymal loss. Also, the percent decrease in GFR at late time points was associated with renal volume preservation and quality of the remnant parenchyma.

Comparison of Mini-Percutaneous Nephrolithotomy and Retrograde Intrarenal Surgery for Renal Pelvic Stones of 2-3 cm.

Backgrounds: Mini-percutaneous nephrolithotomy (M-PCNL) and retrograde intrarenal surgery (RIRS) are commonly used methods for the treatment of kidney stones. The aim of our study is to compare the effectiveness and safety of M-PCNL and RIRS for the treatment of renal pelvic stones with a diameter of 2-3 cm. Materials and Methods: The study included 250 patients, who underwent surgery for renal pelvic stones. M-PCNL and RIRS were performed on 130 and 120 patients, respectively. Age, gender, body mass index of the patients, stone size, the side of surgery, operative times, history of extracorporeal shock-wave lithotripsy, Hounsfield unit (HU) values, the length of hospital stay, stone-free rate (SFR), complication rates according to the modified Clavien system, postoperative hemoglobin loss, postoperative transfusion rates, postoperative narcotic analgesic use, and the number of secondary interventions were recorded. SFR in the postoperative first and third months were calculated. A chi-square test, Student's t-test, and the Wilcoxon test were used for statistical analyses. Results: No statistically significant differences were found in the demographic data, stone size, complication rates defined according to the modified Clavien system, HU values, and postoperative transfusion rates between the patient groups (P > .05). The success rate was statistically significantly higher regarding the postoperative first-month SFR in the M-PCNL group (P < .05). The postoperative third-month SFR after secondary interventions were similar between the groups. The examination of the postoperative hemoglobin loss and narcotic analgesic use and the length of hospital stay revealed superior results in the RIRS group (P < .05). Conclusion: M-PCNL and RIRS are effective and safe methods for the treatment of renal pelvic stones. M-PCNL is advantageous because of high SFR in the postoperative first month and the low need for secondary interventions, whereas RIRS has been found more advantageous in terms of the length of hospital stay, use of narcotic analgesics, and postoperative hemoglobin loss. Further studies on patients with multiple caliceal stones and on patients with a greater stone burden are needed.

Metabolic syndrome is associated worsened erectile function in patients undergoing TURP due to benign prostatic hyperplasia.

INTRODUCTION: Transurethral resection of the prostate (TURP) is the gold standard method for surgical treatment of benign prostatic hyperplasia (BPH). So, the complications of TURP is important, in which erectile dysfunction is the most important. The aim of the present study is to evaluate erectile dysfunction in patients undergoing TURP treatment for BPH and investigate the correlation between metabolic syndrome and erectile dysfunction. MATERIALS AND METHODS: This study included 120 patients who underwent surgery for BPH at Beylikdüzü State Hospital and Okmeydani Training and Research Hospital. IIEF-5 form was administered to the patients before the surgery and six months after the surgery. The Student's t-test, Wilcoxon, and chi-square test were used in the statistical analysis. RESULTS: The patients were investigated by IIEF-5 scoring into three groups (severe, moderate, and non-ED (erectyl disfunction)-mild). The statistical analysis of IIEF-5 form administered to 120 patients who underwent surgery did not show any significant difference before surgery and six months after surgery (p > 0.05). Metabolic syndrome and erectile dysfunction correlation were examined, and a significant correlation was obtained between metabolic syndrome and severe erectile dysfunction (p < 0.05). CONCLUSIONS: IIEF-5 results administered before and after surgery showed no significant difference. The study showed that patients with metabolic syndrome have a higher probability of having erectile dysfunction after TURP compared to patients without metabolic syndrome. Moreover, post-surgery, patients with metabolic syndrome seemed to be affected negatively regarding erectile dysfunction compared to patients with no metabolic syndrome.

Electrocardiographic changes in right ventricular metastatic cardiac tumor mimicking acute ST elevation myocardial infarction: A case of misdiagnosis.

INTRODUCTION: In patients with ST elevation myocardial infarction (STEMI), minimizing the reperfusion time is the goal of therapy worldwide. However, the differential diagnosis is critical and when a patient is encountered with chest pain and ST elevation, STEMI should not be the only diagnosis considered. By detailed history and focused physical examination, it is possible to avoid a mistaken diagnosis. CASE PRESENTATION: In this report, we present a case of a male patient with tongue cancer and accompanying myocardial metastasis that causes electrocardiographic changes, who was initially misdiagnosed with ST elevation myocardial infarction. CONCLUSION: Here, we reported a case of metastatic cancer in the heart which was initially diagnosed as acute myocardial infarction. Echocardiography, computed tomography and magnetic resonance imaging of the heart were used accordingly to confirm the myocardial metastasis.

Evaluation of quality of life in patients undergoing surgery for benign prostatic hyperplasia.

INTRODUCTION: Benign prostatic hyperplasia (BPH) is one of the most common diseases in the world and also one of the most common causes of urinary complaints that occur with increasing age. Thus, BPH should be addressed with surgical procedures. To contribute to the relevant literature, the present study aims to investigate the effects of surgical therapies for BPH on the patients quality of life. MATERIALS AND METHODS: This study included 120 patients who underwent surgery for BPH at a Training and Research Hospital. The short-form health survey (SF-36) was administered to the patients before the surgery and at three months after the surgery. Eight parameters of the SF-36 and mental (MCS) and physical (PCS) component summary scores were calculated. The Student's t-test, Wilcoxon, and chi-square test were used in the statistical analysis. RESULTS: When the eight parameters within the SF-36 health questionnaire were examined separately, the findings showed that patients quality of life increased significantly with respect to physical functioning, social functioning, and role limitations because of emotional problems , vitality, bodily pain, general health perceptions, and mental health domains three months after surgery (p < .001). The PCS and MCS significantly increased after surgery (p < .001). CONCLUSION: The SF-36 questionnaire results showed that a significant improvement in the patients quality of life was observed in patients who underwent surgery for BPH. Our findings suggest that SF-36 could be considered a reliable evaluation test to be used in the patients with BPH after surgery.

Association of Prostatic Volume and Carotid Intima-media Thickness in Patients With Benign Prostatic Hyperplasia.

OBJECTIVE: To assess cardiovascular risk factors and carotid intima-media thickness in patients with benign prostatic hyperplasia. MATERIALS AND METHODS: One hundred and twenty-three patients who were evaluated for the presence of benign prostatic hyperplasia with accompanying symptoms were included in the study. Patients were also examined by cardiology department to assess and measure cardiovascular risk factors, left ventricular functions, and carotid intima-media thickness. RESULTS: Cardiovascular risk factors adjusted carotid intima-media thickness was found to be different between 3 groups, being highest in the severely symptomatic group and lowest in the mildly symptomatic group. Significant correlation of prostatic volume was shown with carotid intima-media thickness after adjusting prostatic volume for body mass index and age, and carotid intima-media thickness for cardiovascular risk factors (r = 0.75 P = .01). Linear regression analysis revealed that carotid intima-media thickness significantly associated with prostatic volume (beta coefficient: 0.628; confidence interval: 37.02-60.1; P = .001). CONCLUSION: We have demonstrated that prostatic tissue has significant association with carotid intima-media thickness in patients with benign prostatic hyperplasia.