Protective effect of cerium oxide on testicular function and oxidative stress after torsion/detorsion in adult male rats.

Testicular torsion (T)/detorsion (D) can cause testicular injury due to the rotation of the spermatic cord and its vessels, therefore it represents an urological emergency that is surgically treated. Oxidative damage occurs in the testis and distant organs because of the overproduction of free radicals and overexpression of proinflammatory cytokines by reperfusion after surgery. Cerium oxide (CeO2) nanoparticles, a material also known as nanoceria, have regenerative antioxidant properties on oxidative stress. The present study aimed to investigate the effects of nanoceria on testis tissues in testicular T/D in rats. A total of 24 rats were equally and randomly divided into four groups: Control, CeO2, T/D and CeO2-T/D groups. Left inguinoscrotal incision was performed in the control group. In the CeO2 group, 0.5 mg/kg CeO2 was given intraperitoneally 30 min before inguinoscrotal incision. In the T/D group, unilateral testicular T/D was performed through an inguinoscrotal incision and rotating the left testis 720˚ clockwise, which was then left ischemic for 120 min, followed by 120 min of reperfusion. In the CeO2-T/D group, 0.5 mg/kg CeO2 was given intraperitoneally 30 min before testicular T/D. At the end of the experiment, testis tissues were removed for histopathological and biochemical examinations. The samples were histologically examined, Glutathione-s transferase (GST), catalase (CAT), paraoxonase (PON) activities and malondialdehyde (MDA) levels were measured via biochemical analysis methods, while the expression levels of p53, Bax and Bcl-2 were detected using immunohistochemistry. The present results revealed statistically significant inter-group differences in PON, CAT and GST activities and MDA levels. GST, CAT and PON activities were significantly higher, whereas MDA levels in the CeO2-T/D group were significantly lower compared with those in the T/D group. The T/D group had increased Bax and decreased Bcl-2 expression levels in their seminiferous tubules compared with the control and CeO2 groups. CeO2 treatment led to downregulation of Bax and upregulation of Bcl-2. The expression of p53 was high in the T/D group compared with that in the control and CeO2 groups, and was upregulated in all germinal cells. However, compared with that in the T/D group, p53 expression was significantly decreased in the CeO2-T/D group. The testicular injury score significantly increased in the CeO2-T/D group compared with the control and CeO2 groups. Rats in the CeO2-T/D group demonstrated significantly milder tissue lesions compared with those in T/D group. The present findings indicated that nanoceria may protect testis in rats against the harmful effects of T/D. Further studies are required to evaluate how CeO2 reduces oxidative stress and cell death in testis tissue that underwent T/D-related injury.

Effect of Cerium Oxide on Kidney and Lung Tissue in Rats with Testicular Torsion/Detorsion.

Introduction: Testicular torsion is a surgical emergency that results in testicular ischemia as a result of rotation of the spermatic cord around itself. Oxidative damage occurs in the testis and distant organs with the overproduction of free radicals and overexpression of proinflammatory cytokines by reperfusion after surgery. In this study, we aimed to investigate the effects of cerium oxide (CeO2), an antioxidant nanoparticle, on lung and kidney tissues in testicular torsion/detorsion (T/D) in rats. Materials and Methods: After ethics committee approval, 24 rats were equally (randomly) divided into 4 groups. Left inguinoscrotal incision was performed in the control (C) group. In group CeO2, 0.5 mg/kg CeO2 was given intraperitoneally 30 minutes before inguinoscrotal incision. In group T/D, unilateral testicular T/D was achieved by performing an inguinoscrotal incision and rotating the left testis 720° clockwise, remaining ischemic for 120 minutes, followed by 120 minutes of reperfusion. In group CeO2-T/D, 0.5 mg/kg CeO2 was given intraperitoneally 30 minutes before testicular T/D. At the end of the experiment, lung and kidney tissues were removed for histopathological and biochemical examinations. Results: Glomerular vacuolization (GV), tubular dilatation (TD), tubular cell degeneration and necrosis (TCDN), leukocyte infiltration (LI), and tubular cell spillage (TCS) in renal tissue were significantly different between groups (p = 0.012, p = 0.049, p < 0.003, p = 0.046, and p = 0.049, respectively). GV and TCDN were significantly decreased in group CeO2-T/D compared to group T/D (p = 0.042 and p = 0.029, respectively). Lung tissue neutrophil infiltration, alveolar thickening, and total lung injury score (TLIS) were significantly different between groups (p = 0.006, p = 0.001, and p = 0.002, respectively). Neutrophil infiltration and TLIS were significantly decreased in group CeO2-T/D compared to group T/D (p = 0.013 and p = 0.033, respectively). Lung and kidney tissue oxidative stress parameters were significantly different between groups (p < 0.05). Renal tissue glutathione-s-transferase (GST), catalase (CAT), and paraoxonase (PON) activities were significantly higher, and malondialdehyde (MDA) levels were significantly lower in group CeO2-T/D than in group T/D (p = 0.049, p = 0.012, p < 0.001, and p = 0.004, respectively). GST and PON activities were higher, and MDA levels were lower in group CeO2-T/D than in group T/D in the lung tissue (p = 0.002, p < 0.001, and p = 0.008, respectively). Discussion. In our study, cerium oxide was shown to reduce histopathological and oxidative damage in the lung and kidney tissue in a rat testis torsion/detorsion model.

Efficiency of radiation-free retrograde intrarenal surgery (RIRS) in children and evaluation of factors affecting surgical success. / Eficiencia de la cirugía intrarenal retrograda sin radiación en niños y evaluación de los factores que afectan el éxito quirúrgico.

OBJECTIVE: To investigate the factors affecting surgical success rates and duration of operation in retrograde intrarenal surgery (RIRS) without fluoroscopy in children. The aim of the study was to demonstrate the efficacy of RIRS without fluoroscopy on the treatment of renal stones in children. MATERIALS AND METHODS: All RIRS procedures were performed on pediatric patients at our clinic from August 2013 to January 2017. We studied 52 pediatric patients who had one stone in one kidney and under went one session. We mapped the kidney collecting system anatomically, and stone localization was defined according to this mapping. Size and localization of the stone, placement of preoperative J stent, use of ureteral access sheath (UAS), and surgical success rates were recorded. The effects of these factors on surgical success rates and the duration of the operations were analyzed. RESULTS: Each patient underwent RIRS once. Of these 52 pediatric patients, 23 (44%) were between 0-5 years of age children (Group 1), 13 (25%) were between 6-11 years of age children (Group 2), and 16 (31%) were between 11-17 years of age children (Group 3). The surgical success rates for each group were 65%, 77%, and 81%, respectively (73% overall). The surgical success rates were found to be affected only by stone size (p<0.01). The durations of the operations were found to be affected by stone size, stone localization, passive dilatation of ureter, and the application of an UAS (p<0.05). CONCLUSION: RIRS is a safe and effective method for the treatment of intrarenal stones in pediatric patients. High success rates can be achieved using kidney mapping without the use of fluoroscopy.

OBJETIVO: Investigar los factores que afectan el éxito quirúrgico y la duración de la cirugía retrógrada intrarenal sin fluoroscopia en niños. El objetivo de este estudio fue demostrar la eficacia de la cirugía retrógrada intrarenal sin fluorosocopia en el tratamiento de litiasis en niños. MÉTODOS: Todos los procedimientos de cirugía retrógrada intrarenal fueron realizados en pacientes pediátricos en nuestra clínica entre agosto 2013 y enero 2017. Estudiamos 52 casos pediátricos con 1 litiasis en 1 riñón y recibieron una sesión. Marcamos el sistema colector renal y la litiasis se definió según ese marcaje. El tamaño y la localización de la piedra, colocación preoperatoria del doble J, la vaina de acceso y la tasa de éxito quirúrgico fueron reportadas. Los efectos de estos factores en el éxito quirúrgico y la duración de las cirugías fueron analizados. RESULTADOS: Cada paciente recibió cirugía retrógrada una vez. De éstos 52 pacientes pediátricos, 23 (44%) tenían entre 0 y 5 años (grupo 1), 12 (25%) entre 6 y 11 años (grupo 2), 16 (31%) entre11 y 17 años (Grupo 3). El éxito quirúrgico en cada grupo fue de 65%, 77% y 81% respectivamente (73% en general). El éxito quirúrgico se vió afectado sólo por el tamaño de la litiasis (p<0,01). La duración de las cirugías se vió afectada por el tamaño de la litiasis, localización de la litiasis, dilatación pasiva del uréter, y uso de la vaina de acceso (p<0,05).CONCLUSIÓN: La cirugía intrarenal retrógrada es segura y efectiva en el tratamiento de litiasis intrarenales en el paciente pediátrico. Altas tasas de éxito se consiguen con el mapeo renal sin fluoroscopia.

Nutritional Factors Related to Male Fertility: Turkish Sample.

This study aimed to investigate the difference between infertile men and healthy (normozoospermic) men in terms of demographic characteristics, dietary habits, anthropometric measurements, and body composition. We included 80 males (40 subfertile and 40 healthy normozoospermic) between the ages of 25 and 54 years. Information was obtained from the participants regarding their socio-demographic characteristics, health status, dietary habits, and food intake. Food frequency questionnaires, food records, anthropometric measurements, body composition, and sperm analysis were statistically evaluated using IBM SPSS Statistics 20 programme. The findings of this study showed that the mean BMI of the subfertile group was significantly higher than that of the normozoospermic group. The frequency of eating out was significantly higher in the subfertile group than in the normozoospermic group. It was also determined that the consumption of fish was significantly lower; in contrast, consumption of sugar sweetened beverages, and alcohol was significantly higher in the subfertile group than in the normozoospermic group. Moreover, it was found that sugar sweetened bevareges, red meat, organ meats consumption are negatively; and that fish, egg, nut consumption are positively correlated with sperm parameters. In summary, in men receiving infertility treatment, excessive consumption of meat and sugary drinks should be considered cautiously. However, fish, nuts and eggs consumption should be provided in line with the nutrition guidelines.

Modified Makuuchi incision in the surgical treatment of renal tumors: Initial results.

OBJECTIVE: To evaluate the modified Makuuchi incision in the surgical treatment of renal tumors. MATERIAL AND METHODS: A total of 29 patients with renal tumors were operated using the modified Makuuchi incision. Patients' age ranged from 48 to 72 years. Twenty-three patients were male, and 6 patients were female. Renal tumors affected the right side in 22 patients and the left side in 7 patients. Twenty-six patients underwent radical nephrectomy, while 3 patients underwent partial nephrectomy. RESULTS: A perfect exposure was achieved with this incision in the surgical field. No serious complications such as bleeding or other organ injuries happened during the surgery. Blood transfusion during surgery was unnecessary. Additional use of analgesics due to wound pain during the postoperative period was not required. Incision-related complications, such as wound infection and wound dehiscence, did not occur in the early postoperative period. Patients had no complaints about the cosmetic appearance of their abdomen due to the incision. Incisional hernia was not observed in patients. CONCLUSION: This type of incision provided a perfect exposure of the field in the surgical treatment of renal tumors.

The efficacy of Tadalafil 5mg in the treatment of lower urinary tract symptoms in patients where alpha blocker treatments have failed in terms of lower urinary tract symptoms. / Eficacia de Tadalafilo 5 mg en el tratamiento de los síntomas del tracto urinario inferior en pacientes tras fallo de los alfabloqueantes.

OBJECTIVES: To investigate the efficacy of tadalafil 5mg in patients with lower urinary tract symptoms who failed alpha blocker treatment. PATIENTS AND METHODS: Twenty-three patients were included. Patient consent was obtained after explaining the efficacy of tadalafil 5mg in lower urinary tract symptoms. Before initiating tadalafil 5mg treatment, prostate cancer and urinary tract infection in the patients were eliminated. IPSS, IIEF-5 and Qmax values were assessed before and one month after tadalafil 5mg treatment. Difference between two assessments was evaluated by the Wilcoxon method. RESULTS: After 1 month of Tadalafil 5mg treatment, IPSS decreased and IIEF-5 and Qmax increased. The difference between two assessments were statistically significant. CONCLUSION: Tadalafil 5mg once daily in the treatment of BPH/LUTS is found to be successful in patients who failed previous alpha blocker treatment.

OBJETIVOS: Investigar la eficacia de tadalafilo 5 mg en pacientes con síntomas del tracto urinario inferior (STUI) tras fallo de los alfabloqueantes. PACIENTES Y MÉTODOS: Treinta y tres pacientes fueron incluidos. Se obtuvo consentimiento informado en todos los casos tras explicarles la eficacia del tadalafilo 5 mg en el tratamiento de los STUI. Antes de iniciar el tratamiento se descartaron cáncer de próstata e infección urinaria. Se evaluaron los valores de los cuestionarios IPSS, IIEF-5 y el Q max antes del tratamiento y al mes del tratamiento. Las diferencias entre los grupos se evaluaron utilizando el método de Wilcoxon.    RESULTADOS: Después de un mes con tadalafilo 5 mg, el IPSS disminuyó, y el IIEF-5 y el Q max aumentaron. Las diferencias fueron estadísticamente significativas. CONCLUSIONES: Se ha visto que el tadalafilo 5 mg una vez al día es eficaz en el tratamiento de los STUI/HBP en pacientes con fallo previo del tratamiento con alfabloqueantes.

A method that facilitates urethral catheterization after internal urethrotomy.

Internal urethrotomy is the first treatment option of the urethral stricture. Urethral catheterization may be difficult after internal urethrotomy in some patients. In this case report, we describe a method to facilitate insertion of urethral catheter in patients in whom urethral catheterization is challenging following internal urethrotomy.

Exenatide reduces oxidative stress and cell death in testis in iron overload rat model.

Glucagon-like peptide-1 (GLP-1) has been demonstrated to affect the oxidative stress status in several in vitro, in vivo and clinical studies. The aim of the present study was to evaluate the effect of a GLP-1 analogue, exenatide, on oxidative stress parameters and apoptotic markers in testicular cells in an iron overload rat model. To obtain this model, the animals were randomly divided into three groups (n=6/group). Rats in the control group received intraperitoneal injections of saline. Intraperitoneal iron dextran (60 mg/kg/day) was given to Group FE for 5 days a week for 4 weeks. The third group (Group Fe +E) was given subcutaneous injections of 10 µg/kg exenatide in two divided doses for 4 weeks in addition to iron dextran. Testes of all rats were immediately removed for immunohistochemical staining and to measure the malondialdehyde level and superoxide dismutase enzyme activity. A significant reduction was observed in caspase-8 and -3 enzyme staining in testicular stromal and endothelial cells in exenatide injected iron overloaded rats when compared with controls. Oxidative stress markers malondialdehyde levels and superoxide dismutase enzyme activities were also significantly lower in exenatide-injected rats when compared with controls. These findings indicate that exenatide may be protective against the harmful effects of iron accumulation in testis. Further studies are required to evaluate how exenatide reduces oxidative stress and cell death in iron overloaded testis tissue.

Retrograde intrarenal surgery by flexible ureteroscope in patients with spinal deformities.

OBJECTIVE: To present our experience with retrograde intrarenal surgery (RIRS) for managing renal stones in patients with spinal deformities. DESIGN: We retrospectively reviewed the records of patients. METHODS: We retrospectively reviewed the records of seven patients with congenital scoliosis (n = 5), spina bifida (n = 2) who had undergone RIRS for renal stones. Stone-free status was determined by CT 30 days after the procedure and was defined as the absence of stones in the kidney or residual fragments ≤1 mm. RESULTS: Mean patient age was 27 years (18-45 years), and mean stone size was 176 mm (143-340 mm). The average operative time was 38 minutes (25-53 minutes), and postoperative hospital stay was 1 day (1-2 days). A stone-free status was obtained in six (85.7 %) patients, and one patient was considered to have treatment failure. This patient was managed by a repeat RIRS. A Double-J stent was placed at the end of the procedure in all (100 %) patients. No severe complications, either from anesthesia or the surgical procedure, were observed, and no blood transfusion was reported. CONCLUSIONS: The good clearance rate with a low incidence of complications shown by the present study has demonstrated that RIRS is a safe and effective procedure for renal stones in patients with spinal deformities.

Comparison of Dilation Methods in Percutaneous Nephrolithotomy: Which One Is More Successful?

OBJECTIVE: Creation of the access tract is an important step in percutaneous nephrolithotomy (PNL). In this study, we compared the efficiency and safety of Amplatz, Alken, and balloon dilation methods in the creation of the access tract. MATERIALS AND METHODS: Data from 487 PNL patients admitted to 517 renal units in 3 centers were analyzed. The Amplatz (280 patients), Alken (142 patients), and balloon (95 patients) dilation methods were compared for their success, duration of the dilation, injury to the collecting system, durations of fluoroscopy and surgery, stone-free and complication rates, pre- and postoperative hematocrit levels, and need for blood transfusion. RESULTS: The dilation methods did not significantly differ with respect to patient demographic data, mean stone area, decrease in hematocrit, need for blood transfusion, unsuccessful tract dilation, injury to the collecting system, stone-free rate, and rate of postoperative complications. The mean fluoroscopy times during Amplatz, Alken, and balloon dilation were 288.52 ± 164.67, 287.34 ± 164.99, and 169.23 ± 21 seconds, respectively. The mean duration of surgery was 96.48 ± 46.07, 94.72 ± 42.25, and 78 ± 25.96 minutes, respectively. The duration of tract creation was 328.67 ± 172.99, 325.14 ± 175.70, and 203.50 ± 32.76 seconds, respectively. The durations of surgery and tract creation were significantly shorter in the balloon dilation group. CONCLUSION: None of the dilation methods was significantly superior in terms of surgical success, efficiency, or safety. Although balloon dilation was advantageous with respect to time parameters, the role of surgical experience should not be ignored.

Seperation of dorsal vein complex from the urethra by blunt finger dissection during radical retropubic prostatectomy.

We present our initial experience on the isolation of dorsal vein complex by blunt finger dissection in 26 patients with localised prostate cancer who underwent open retropubic radical prostatectomy. Loss of blood was between 300 and 500 mL (mean 350 mL). Two of 26 patients (7.6%) required blood transfusion. There was no positive surgical margin at prostatic apex in the patients. Twenty four of our patients (92.4%) were continent on the 3(rd) month. Control of dorsal vein complex is very important to decrease blood loss and to improve intraoperative exposure of retropubic area in order to get negative margin of prostatic apex and to provide the urethra long enough for a nice urethrovesical anastomosis. According to our initial experience, this technique seems to provide these aims.

The Effect of Metabolic Syndrome on the Success and Complications of Percutaneous Nephrolitotomy.

BACKGROUND: The aim of this study was to investigate the effect of Metabolic syndrome (MetS) on the success and complications of percutaneous nephrolithotomy (PNL). METHODS: Two hundred ten patients who had undergone PNL for kidney stones in our clinic between May 2012 and May 2014 were retrospectively analyzed. The patients were divided into two groups based on whether they had diagnostic criteria for MetS. All patients had lower pole kidney stones between 15 and 20 mm. Complication rates between groups were evaluated using a modified Clavien grading system. RESULTS: Group1 was a standard PNL group and group 2 consisted of patients with MetS. Mean stone size was 293.25 ± 102.4 mm(2) for group 1 and 301.10 ± 169.5 mm(2) for group 2 (p < 0.05). Mean hospitalization days, fluoroscopy duration, and mean hematocrit loss were significantly higher in group 2. Mean operative time and need for blood transfusions were higher in group 2 but statistically insignificant. One hundred twenty five patients in group 1 (96.1%) and 72 patients in group 2 (90%) obtained stone-free state. CONCLUSIONS: Our study results reveal an increase in complications and morbidity for patients with MetS during PNL.

Management of renal cysts.

BACKGROUND AND OBJECTIVES: Renal cysts have a high prevalence in the general population, and their estimated incidence increases with age. Renal cyst aspiration (usually with sclerotherapy) or open/laparoscopic decortication is a generally effective and safe method in the treatment of symptomatic simple renal cysts. The success rates of laparoscopic decortication and percutaneous aspiration-sclerotherapy were compared to assist in the decision making for the procedure. METHODS: A total of 184 patients with symptomatic simple renal cysts were treated with either laparoscopic decortication in 149 cases or percutaneous aspiration-sclerotherapy in 35 cases. The follow-up period was approximately 35 months, and the symptomatic and radiologic success rates of the 2 techniques were compared retrospectively. RESULTS: Laparoscopic decortication was found to have high success rates, a low recurrence rate, and minimal morbidity. Percutaneous aspiration-sclerotherapy is an outpatient procedure with a minimally higher recurrence rate. CONCLUSION: When a symptomatic cyst is encountered and treatment of the cyst is indicated, laparoscopic decortication is a more efficient method that offers better results than percutaneous aspiration-sclerotherapy.

A rare emergency: testicular torsion in the inguinal canal.

Objectives. To report our experience and present the largest series of testicular torsion cases in the inguinal canal. Material and Methods. The clinical data of 13 patients with testicular torsion in the inguinal canal treated between 2005 and 2013 were reviewed. Recorded patient age, whether the testes were palpable or not, side of the affected testes, the presence of hernia, ischemia time, and operation outcomes were assessed. Results. Patient age ranged from 8 to 70 months (29.15 ± 20.22). Mean ischemia time was 16.5 ± 21.3 hours. Accompanying inguinal hernia was present in 92% of the cases (12/13). Four of the thirteen patients (30.8%) were treated by orchiectomy because the necrosis was present after prolonged ischemia time. Nine patients (69.2%) were treated by single session orchidopexy. Conclusion. Torsion of testes in the inguinal canal is a rare disease, but with rapid diagnosis, affected testes can be salvaged, but the key factor is to keep this condition in mind.

Comparative analysis of pedicular vascular control techniques during laparoscopic nephrectomy: en bloc stapling or separate ligation?

OBJECTIVE: To compare the safety and efficacy of en bloc stapling and separate ligation techniques for renal vascular control during laparoscopic nephrectomy. PATIENTS AND METHODS: Clinical data were collected from 60 patients who underwent laparoscopic nephrectomies using en bloc stapling (n = 27, group 1) or the separate ligation method (n = 33, group 2). Comparative analysis was carried out between the two groups, examining operative times, blood loss, intra- and postoperative complications and hospital stay. RESULTS: Compared with the separate ligation method, the en bloc hilar control technique was associated with a shorter total operating time (98 vs. 121 min, p = 0.029). However, both groups were similar in terms of estimated blood loss, hemoglobin drop, changes in creatinine level and postoperative hospital stay. The total complication rates in group 1 and 2 were 3.7 and 15.1%, respectively, with a statistically significant difference. There were no complications related to the use of the endo-GIA stapler and no patients required conversion to open surgery in group 1. In group 2, 2 patients required conversion to open surgery, including 1 due to renal vein bleeding secondary to inaccurate vascular control and the other due to bleeding from the vena cava during dissection. In addition, 1 patient had a superficial bowel injury that was repaired laparoscopically and another had a superficial liver tear that was managed without conversion or transfusion. CONCLUSION: En bloc ligation of the renal hilum is an easy and reliable technique that allows safe and fast control of the renal pedicle.

Comparison of complications associated with standard and totally tubeless percutaneous nephrolithotomy according to modified Clavien grading: a multicenter retrospective study.

The aim of this study was to compare the complications of standard and totally tubeless percutaneous nephrolithotomy (PCNL) based on the modified Clavien complication grading system. We retrospectively evaluated the complications of 290 consecutive patients who had undergone standard or totally tubeless PCNL at four institutes between January 2010 and August 2012 based on the modified Clavien scale. The totally tubeless cases were classified as Group 1 and the cases to which a Malecot re-entry catheter was applied were classified as Group 2. The postoperative complications were recorded according to the modified Clavien complication grading system. Statistically significant differences were observed only in the first-degree injury class between the two groups based on the modified Clavien classification. The requirement for blood transfusion and prolonged percutaneous access site leakage were more frequent in Group 2, but these differences were not statistically significant. We also performed a pain evaluation by monitoring postoperative analgesia demands. In Group 1, the analgesic demand rates in the 1(st) and 6(th) postoperative hours were 64.6% and 31.5%, respectively. In Group 2, the analgesic demand rates were 87.5% and 58.75% in the 1(st) and 6(th) postoperative hours, respectively. The mean ± standard deviation of analgesic doses in the first 6 hours was 0.96 ± 0.7 and 1.46 ± 0.6 in Groups 1 and 2, respectively. These differences were statistically significant. Based on our results, we can conclude that the tubeless technique has fewer complications, improved postoperative patient comfort, shorter hospitalization times, and a reduced need for analgesics, suggesting that tubeless PCNL should be the standard approach. For suitable cases, this technique may be used safely as the standard PCNL approach.

Papillary ureteral neoplasm of low malignant potential in the upper urinary tract: endoscopic treatment.

INTRODUCTION: Papillary ureteral neoplasm of low malignant potential (PUNLMP) is a rare diagnosis, and to our knowledge, has not yet been reported in the upper urinary tract. In this study, we aimed to present our experience in managing a very rare diagnosis, PUNLMP, in the upper urinary tract, with endoscopic treatment. MATERIALS AND METHODS: Files of patients who received surgery between January 2007 and January 2013 for upper urinary tract tumors were reviewed and patients treated for PUNLMP in the upper urinary tract in 4 urology clinics were reviewed. Patients included in the study had at most 2 tumors in the ureter and had a pathology of PUNLMP. RESULTS: The study included 11 patients with a mean age of 58.5 years. There were 9 men, and 2 women with a smoking rate of 81.8%. Nine patients (8 in the distal and 1 in the mid ureter) were managed using a semirigid ureteroscope. Two patients (1 with mid ureteral and 1 proximal) were treated using flexible ureteroscopy. The mean hospital stay was 1.56 days. Mean surgical time was 37.18 ± 7.14 minutes. The mean follow-up was 31.5 (range, 7-72) months. In the follow-ups, 3 patients had recurrences of 3, 2, and 4 mm in 9, 15, and 17 months, respectively. CONCLUSION: For tumors with a low risk of progression and relatively low risk of recurrence, organ-sparing treatments should be the choice of preference. To support our initial findings, randomized controlled studies on larger cohorts should be designed.