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OBJECTIVE: To contribute to the literature by sharing the clinical presentation, surgical approach, postoperative complications management, and follow-up protocols of the patients we operated on due to intrascrotal extratesticular mass. METHODS: Thirty-two patients admitted due to intrascrotal extratesticular mass were included in the study. Demographic and clinical characteristics of the patients such as age, initial clinical presentation, physical examination, radiological imaging findings, such as scrotal Doppler ultrasonography and magnetic resonance imaging, mass size, and characteristics, surgical treatment procedures, operation notes, and patient follow-up visits were retrospectively examined and evaluated from the patient files. RESULTS: The median age of the 32 individuals included in the study was 52 (interquartile range: [45.0-60.5]) years. The primary reason for initial presentation was a palpable mass in 25 (78.1%) patients, pain in 13 (40.6%) patients, and scrotal swelling in 8 (25%) patients. The median mass diameter was 4.4 (interquartile range: [3.1-5.7]) cm. Surgical treatment involved inguinal excision in 29 cases (90.6%) and inguinoscrotal excision in 3 cases (9.4%). All patients were treated with testicle-sparing surgery. The most common tumor location, observed in 27 cases (84.3%), was the epididymis. The most frequent histopathological diagnosis was epididymal cyst, identified in 13 patients (40.6%). Pathology results showed that the mass was removed with negative margins in all patients. CONCLUSION: Testicular-sparing surgery through the inguinal approach is one of the surgical methods that can be preferred for intrascrotal extratesticular masses. This approach can both preserve the testicle and achieve successful surgical results. Studies with larger samples are needed on this subject. TRIAL REGISTRATION: This study was approved by the Erzurum Medicine Faculty University Local Ethics Committee (approval number: BAEK 2023/08-105).
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PURPOSE: Identifying factors predicting the spontaneous passage of distal ureteral stones and evaluating the effectiveness of artificial intelligence in prediction. MATERIALS AND METHODS: The files of patients presenting with distal ureteral stones were retrospectively evaluated. Those who experienced spontaneous passage were assigned to Group P, while those who did not were assigned to Group N. Demographic and clinical data of both groups were compared. Then, logistic regression analysis was performed to determine the factors predicting spontaneous stone passage. Based on these factors, a logistic regression model was prepared, and artificial intelligence algorithms trained on the dataset were compared with this model to evaluate the effectiveness of artificial intelligence in predicting spontaneous stone passage. RESULTS: When comparing stone characteristics and NCCT findings, it was found that the stone size was significantly smaller in Group P (4.9 ± 1.7 mm vs. 6.8 ± 1.4 mm), while the ureteral diameter was significantly higher in Group P (3.3 ± 0.9 mm vs. 3.1 ± 1.1 mm) (p < 0.05). Parameters such as stone HU, stone radiopacity, renal pelvis AP diameter, and perirenal stranding were similar between the groups. In multivariate analysis, stone size and alpha-blocker usage were significant factors in predicting spontaneous stone passage. The ROC analysis for the logistic regression model constructed from the significant variables revealed an area under the curve (AUC) of 0.835, with sensitivity of 80.1% and specificity of 68.4%. AI algorithms predicted the spontaneous stone passage up to 92% sensitivity and up to 86% specifity. CONCLUSIONS: AI algorithms are high-powered alternatives that can be used in the prediction of spontaneous distal ureteral stone passage.
