A Retrospective Analysis of 83 Patients with Testicular Mass Who Underwent Testis-Sparing Surgery: The Eurasian Uro-oncology Association Multicenter Study.

INTRODUCTION: Herein, we analyzed the histopathological, oncological and functional outcomes of testis-sparing surgery (TSS) in patients with distinct risk for testicular cancer. METHODS: This is a multicenter retrospective study on consecutive patients who underwent TSS. Patients were categorized in high- or low-risk testicular germ cell tumor (TGCT) according to the presence/absence of features compatible with testicular dysgenesis syndrome. Histology was categorized per size and risk groups. RESULTS: TSS was performed in 83 patients (86 tumors) of them, 27 in the high-risk group. Fifty-nine patients had a non-tumoral contralateral testis present. Sixty masses and 26 masses were benign and TGCTs, respectively. No statistical differences were observed in mean age (30.9 ± 10.32 years), pathological tumor size (14.67 ± 6.7 mm) between risk groups or between benign and malignant tumors (p = 0.608). When categorized per risk groups, 22 (73.3%) and 4 (7.1%) of the TSS specimens were malignant in the high- and low-risk patient groups, respectively. Univariate analysis showed that the only independent variable significantly related to malignant outcome was previous history of TGCT. During a mean follow-up of 25.5 ± 22.7 months, no patient developed systemic disease. Local recurrence was detected in 5 patients and received radical orchiectomy. Postoperative testosterone levels remained normal in 88% of those patients with normal preoperative level. No erectile dysfunction was reported in patients with benign lesions. CONCLUSION: TSS is a safe and feasible approach with adequate cancer control, and preservation of sexual function is possible in 2/3 of patients harboring malignancy. Incidence of TGCT varies extremely between patients at high and low risk for TGCT requiring a careful consideration and counseling.

Recurrent bladder cystitis: who takes the role?

PURPOSE: In this review, we discuss how the approach should be throughout the symptomatic and diagnostic process of recurrent bladder cystitis. METHODS AND RESULTS: The available literature regarding recurrent bladder cystitis in the PubMed database has been reviewed. While urinary tract infections (UTIs) are amongst the most commonly seen diseases in society, the probability of having a UTI in women within a year is 15%. Within a lifetime, it is above 50%. In addition to the related comorbidities and decreased quality of life, the resulting cost constitutes a serious burden on national economies. Recurrent UTI (rUTI) refers to a group of patients who have suffered from a UTI at least three times in the last 12 months or at least two times during the previous 6 months and have diminished quality of life. During this chronic and bothersome process, it is also complicated as to who is going to make the diagnosis of patients and by whom treatment or follow-up will be provided. CONCLUSION: Although there is no clear answer to this issue in the literature, the urologist might be the moderator of this chronic process as the physician who most frequently faces this condition in daily practice, is most aware of the uroanatomy as well as the pathophysiology and performs relevant operations in cases of necessity. At this point, rather than limiting the evaluation and treatment to a single specialty, it is crucial to solve the problem by using a multidisciplinary approach.