Purpose: To predict prostatic carcinoma using a logistic regression model on prebiopsy peripheral blood samples. Materials and Methods: Data of a total of 873 patients who consulted Urology Outpatient Clinics of Fatih Sultan Mehmet Training and Research Hospital between February 2008 and April 2014 scheduled for prostate biopsy were screened retrospectively. PSA levels, prostate volumes, prebiopsy whole blood cell counts, neutrophil and platelet counts, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), biopsy results and Gleason scores in patients who had established diagnosis of prostate cancer (PCa) were evaluated. Results: This study was performed on a total of 873 cases, with an age range 48-76 years, divided into three groups as for biopsy results. with diagnoses of benign prostatic hyperplasia (BPH) (n=304, 34.8 %), PCa (n=265, 30.4 %) and histological prostatitis (n=304; 34.8 %). Intra-and intergroup comparative evaluations were performed.White blood cell and neutrophil counts in the histological prostatitis group were significantly higher than those of the BPH and PCa groups (p=0.001; p=0.004; p<0.01). A statistically significant intergroup difference was found for PLR (p=0.041; p<0.05) but not lymphocyte count (p>0.05). According to pairwise comparisons, PLR were significantly higher in the PCa group relative to BPH group (p=0.018, p<0.05, respectively). Though not statistically significant, higher PLR in cases with PCa in comparison with the prostatitis group was remarkable (p=0.067, and p>0.05, respectively). Conclusions: Meta-analyses showed that in patients with PSA levels over 4 ng/ml, positive predictive value of PSA is only 25 percent. Therefore, novel markers which can both detect clinically significant prostate cancer, and also prevent unnecessary biopsies are needed. Relevant to this issue in addition to PSA density, velocity, and PCA3, various markers have been analyzed. In the present study, PLR were found to be the additional predictor of prostatic carcinoma.

Purpose The aim of the study was to investigate white blood cell counts and neutrophil to lymphocyte ratio (NLR) as markers of systemic inflammation in the diagnosis of localized testicular cancer as a malignancy with initially low volume.Materials and Methods Thirty-six patients with localized testicular cancer with a mean age of 34.22±14.89 years and 36 healthy controls with a mean age of 26.67±2.89 years were enrolled in the study. White blood cell counts and NLR were calculated from complete blood cell counts.Results White blood cell counts and NLR were statistically significantly higher in patients with testicular cancer compared with the control group (p<0.0001 for all).Conclusions Both white blood cell counts and NLR can be used as a simple test in the diagnosis of testicular cancer besides the well-known accurate serum tumor markers as AFP (alpha fetoprotein), hCG (human chorionic gonadotropin) and LDH (lactate dehydrogenase).

Objective: The aim of this study was to compare depression and sexual dysfunctions observed in primary and secondary infertile patients. Material and method: The study was performed in 39 primary and 31 secondary infertile male patients. Male sexual health was evaluated using the International Index of Erectile Function (IIEF) score and depression with Beck Depression Inventory (BDI). Results: Mean age of the participants and their partners were 31.54 ± 5.37 (range, 24-48 yrs), and 28.16 ± 5.58 (range, 20-46 yrs) years, respectively. Mean duration of their marriage ranged between 1 and 17 years (mean, 5.06 ± 4.15 yrs). A statistically significant intergroup difference was detected between groups as for BDI scores (p = 0.015; p < 0. 05). BDI scores of the primary group were significantly lower than those of the secondary group. A statistically and extremely significant difference was detected between IIEF scores of the groups (p = 0.006; p < 0.01). IIEF scores of the primary infertile group were higher than those of the secondary group. Conclusion: Our study, frequency of the depression and erectile dysfunction seen in the patients with secondary infertility was seen significantly higher than the patients with primary infertility.KEY WORDS: Infertility; Male sexual dysfunction; Depression; Secondary infertile man. clear definition of this time, the 12 months period is also accepted for the secondary infertility by many authors. Diagnosis of infertility can be made in nearly 15% of the couples who want to have a baby and primary or secondary infertility are detected in 90 and 10% of them (3). One of the basic and primitive instincts in human beings is reproductive instinct. Reproductive deficiency frequently creates a social stigma, which is perceived as a disgraceful condition (4). Infertility emerges from a sudden and unexpected life crisis, which can be diagnosed in the long run. It results in excessive stressful problems, which strain adjustment mechanisms (5). Studies analyzing the association between infertility and psychological functions have used one of the following models. One of them is psychological infertility model, which asserts the role of an existing psychopathology on the etiology of infertility and the other model (psychological result) claims that psychological problems arise as a result of infertility (6). Recently direct correlation of mental stress with infertility problems and its impact on the outcomes of infertility treatment has been demonstrated. For example it has been revealed that during natural disasters like earthquakes, sperm quality activities of seminal plasma superoxide dismutase and arginine decrease, and nitric oxide levels increase in men under stress (7,8). Since psychiatric disorders are more frequently analyzed during infertility investigations, scales specific to infertility process haven't been developed yet (9). In developed countries, it appears to be appropriate to take a detailed history about psychological status of the infertile couple. The rationale of this appr...

Objectives:To evaluate protective effects of darbepoetin and tadalafil against ischemia-reperfusion injury in ipsilateral and contralateral testicle.Materials and Methods:Thirty 3-month-old adult male Wistar-Albino rats were randomly divided into 5 groups (A-E). Sham operation was performed in the first group. In Group B, rats did not received any medication after creating 720 degrees torsion of the left testis. The rats in Group C, D and E received darbepoetin, tadalafil, and darbepoetin/tadalafil combination 30 minutes after creating 720 degrees torsion of the left testis, respectively. The testes of rats in these three groups were detorsioned at 90 minutes after drug administration. Both testes were removed at 30 minutes after detorsion.Results:There were significant differences between the groups in terms of the degree of histopathological damage, Johnsen score, fibrosis score and caspase-3 immunoreactivity in the torsioned testes (p: 0.000). The results for each parameter in the left testes were significantly better in the darbepoetin / tadalafil combination group. Similarly, there were also significant differences in the contralateral testes (p: 0.000).Conclusion:The active substances darbepoetin and tadalafil that were used as a combination had protective effects on both testes and produced out better results in preserving testicular histology. Especially in cases where it is not possible to rescue the torsioned testis, this result was more noticeable in the contralateral testis.

Purpose: The freehand (FH) technique of transperineal prostate biopsy using commercialized needle access systems facilitates a reduction in anesthesia requirements from general to local or local/sedation. We sought to compare the efficacy and complication rates of the FH method with those of the standard gridbased (GB) method. Materials and Methods: The GB method was performed from 2014 to 2018, and the updated FH technique was performed from 2018 to 2020, yielding comparative cohorts of 174 and 304, respectively. Results: The FH and GB techniques demonstrated equivalent yields of !Gleason grade group (GGG)-2 prostate cancer (PCa). The FH group had a significantly higher mean number of cores with !GGG-2 PCa involvement (p[0.011) but a significantly lower mean number of biopsy samples (p <0.01). The urinary retention rate of the GB group (10%) was significantly higher than that of the FH group (1%; p <0.01). The rates of !GGG-2 PCa involvement in the anterior (GB, 31%) and anteromedial (FH, 22%) sectors were higher than those in other sectors (range, 0%e9%). For multiparametric magnetic resonance imaging, the rate of !GGG-2 PCa detection in the anteromedial prostate (23%) was nearly half that in other locations (range, 38%e55%). Conclusions: Compared with GB transperineal biopsy, FH transperineal biopsy demonstrates an equivalent cancer yield with no risk of sepsis, a significantly reduced risk of urinary retention, and reduced anesthesia needs. The higher number of cores with !GGG-2 PCa involvement in the FH group suggests that FH transperineal biopsy can sample the prostate better than GB-transperineal biopsy can.

Objective: Testicular cancers, which are less common than other cancers, are important in terms of being seen in young people. Physical examination, imaging, laboratory and tumor markers are used for diagnosis. There are some studies of some blood parameters that can be involved in inflammation and tumorogenesis. We retrospectively compared hematological values measured in our patients who were diagnosed with testicular tumor in comparison with patients with similar age group who underwent varicocelectomy repair. Materials and methods: This cross-sectional retrospective study included 120 patients who underwent radical inguinal orchiectomy for testicular tumor between January 2010 and December 2018, and 171 patients who underwent varicocelectomy as a control group. Patients with an active infection and hematological disorders were excluded from the study. We evaulated hematological parameters including neutrophil (NEU), lymphocyte (LYM), platelet (PLT) count, and mean platelet volume. The study was conducted on 291 patients. divided in two groups: tumor (n = 120) and varicocele (n = 171). Results: There was no statistically significant difference between the groups in terms of PLT / lymphocyte ratio and mean platelet volume (MPV) levels (p > 0.05). The neutrophil /lymphocyte ratio (NLR) of the tumor group was significantly higher than the varicocele group (p = 0.001; p < 0.05). There was a statistically significant difference between the tumor stages in terms of PLT / Lymphocyte ratios (p = 0.006; p < 0.05). Conclusions: There was only a statistically significant increase in NLR values in the testicular tumor group compared to the varicocele group. Larger, randomized controlled studies are needed at this field.

Cystitis glandularis is a proliferative disease of the urinary bladder epithelium. It is rare in children. We report a case of a 23-yearold female with intractable macroscopic hematuria and severe irritative bladder symptoms persisting for 13 years. The patient, who had undergone open and endoscopic bladder surgery at various medical centres, is currently being followed up at our clinic. Cystoscopy revealed multiple edematous papillary tumours on the bladder neck, trigone, and lateral wall on both sides and she underwent transurethral resection of the bladder tumour. The pathological diagnosis was cystitis glandularis in accordance with the histopathological reports obtained from the other medical centres. Her condition was resistant to transurethral resection, partial cystectomy, intravesical mitomycin, and bacillus Calmette-Guerin (BCG) treatment; it eventually could have affected the upper urinary tract. Oral steroid treatment was given for 6 months; after treatment, her symptoms improved and the cystoscopy revealed a dramatic improvement in her condition.

SUMMARY INTRODUCTION Due to spongiofibrosis and inflammatory processes underlying the pathogenesis of urethral stricture, it is possible that the neutrophil-lymphocyte ratio (NLR) may give essential information about the course of the disease and recurrence possibilities. Our study aims to evaluate the correlation between NLR and recurrence rates. METHODS A total of 512 patients who underwent direct visual internal urethrotomy (DVIU) due to urethral stricture in our clinic between February 2010 and January 2018 were evaluated retrospectively. RESULTS The median follow up for non-recurrent and recurrent groups after DVIU was 30 and 36 months, respectively. During the follow-up, 280 (54.7%) of the patients had recurrences, and 232 (45,3%) had no recurrences. The mean time for recurrence after DVIU was 6,5±1,4 months, with a range of 1-36 months. The mean NLR in the non-recurrence group was 2,02±0,87, with a median of 1.9, and 3,66±2,30, with a median of 3 in the recurrence group. A highly significant statistical difference was observed between two groups in terms of neutrophil count and NLR (p: 0.000 – both). The area under curve value for NLR was 0.767, with a standard error of 0.021 (95% CI 0.727-0.808). The cut-off value of NLR was determined as 2.25, with a 70% sensitivity and 67,7% specificity. CONCLUSION By using NLR, the inflammatory features of the urethral tissue can be predicted, and possible recurrences after surgery can be estimated. Consequently, open urethroplasty techniques can be used in cases with a significant NLR value instead of the recurrent endoscopic procedure.