PurposeTo evaluate the predictive role of the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet count (PLT) in the diagnosis of testicular torsion (TT) and testicular viability following TT.Materials and MethodsWe analyzed two study groups in this retrospective study: 75 patients with a diagnosis of TT (group 1) and 56 age-matched healthy subjects (group 2). We performed a complete blood count as a part of the diagnostic procedure, and NLR, PLR, MPV, and PLT values were recorded. We compared the patient and control groups in terms of these parameters. Then, TT patients were divided into two subgroups according to the time elapsed since the onset of symptoms. Subsequently, we evaluated the relationship between the duration of symptoms and these parameters.ResultsThere were significant differences between groups 1 and 2 in NLR, PLR, and PLT (p<0.001 for all). There was no predictive role of MPV in the diagnosis of TT (p=0.328). We determined significantly high sensitivity and specificity levels for NLR in the prediction of TT diagnosis (84% and 92%, respectively). Furthermore, NLR was significantly related to the duration of symptoms in TT patients (p=0.01).ConclusionsNLR may be a useful parameter in the diagnosis of TT. Furthermore, NLR may be used as a predictive factor for testicular viability following TT.

Cite as: Can Urol Assoc J 2014;8(11-12):e894-900. http://dx.doi.org/10.5489/cuaj.2208 Published online December 15, 2014. Abstract Introduction:We assess the effect of video-based education on patient anxiety during transrectal prostate biopsy. Methods: A total of 246 patients who underwent transrectal prostate biopsy were prospectively enrolled in the study. Group 1 included 123 patients who received both written and video-based education, while Group 2 included 123 patients who received only written instructions regarding prostate biopsies. State-Trait Anxiety Inventory (STAI) was used to assess state and trait anxiety (STAI-S/T) After completing the STAI-S and STAI-T questionnaires, all patients in Group 1 received written information and video-based education and they again completed STAI-S before the biopsy. On the contrary, after completing the STAI-S and STAI-T questionnaires, the patients in Group 2 received only written information and then they completed the STAI-S before the biopsy. Moreover, a visual analog scale (VAS) was used to assess pain scores during digital rectal examination, probe insertion, periprostatic local anesthesic infiltration, and biopsy. Results: No difference was noted between 2 groups regarding VAS scores. Comparing the 2 groups on baseline anxiety, we found that trait anxiety scores (STAI-T) were similar (p = 0.238). Preinformation STAI-S scores were similar in both groups (p = 0.889) and they both indicated high anxiety levels (score ≥42). While postinformation STAI-S scores remained high in Group 2, post-information STAI-S scores significantly decreased in Group 1 (p = 0.01). Conclusions: Undergoing a prostate biopsy is stressful and may cause anxiety for patients. Video-based education about the procedure can diminish patient anxiety.

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Objective To examine the the effect of body mass index (BMI) on PNL results and complications with a large number of patients.Materials and Methods A total of 958 patients were included in the study, who underwent percutaneous nephrolithotomy in our clinic between 2008 and 2015. Patients were divided into 2 groups according to their body mass index. Patients with a BMI < 30 kg/m2 were classified as group 1 (n:676) and patients with a BMI ≥ 30 kg/m2 were classified as group 2 (n:282). Achieving stone-free status or having residual stones of ≤ 4 mm were considered as operational success.Results The mean age was 47.9 years for group 1 and 48.9 years for group 2 patients. At postoperative first month CT analysis, residual stone was not observed in 466 patients (69%) of group 1 and 20 (72%) patients of group 2. There was no significant difference between the groups in terms of stone-free status (p=0.348). There was no significant difference between two groups complications. Also, there was no difference between the groups for requiring additional intervention (p=0.924). No other complications were observed in the patients.Conclusions BMI does not affect the outcomes of percutaneous nephrolithotomy as well as complication rate.

IntroductionTo assess the clinical presentation of patients who underwent surgical exploration for acute scrotum and to investigate the potentially related factors for differential dignosis.Material and methodsWe retrospectively analyzed the medical records of 97 patients who underwent surgical exploration for acute scrotum between May 2007 and July 2013. The patients were divided into two groups as follows: Group1 included patients with testicular torsion (TT) and Group 2 contained patients with acute scrotal pathologies other than TT, including torsion of the testicular appendage, epididymo-orchitis, trauma and Henoch-Schönlein purpura. The physical examination findings, colour Doppler ultrasound (CDUS) and laboratory findings for the groups were compared.ResultsIn total, 97 scrotal explorations were carried out for acute scrotum. Group 1 included 72 patients (74.2%) and Group 2 included 25 patients (25.8%). Group 2 was comprised of patients with torsion of the testicular appendage (n = 13), epididymo-orchitis (n = 8), testicular trauma (n = 2) and Henoch-Schönlein purpura (n = 2). In Group 1, 32 cases (44.4%) presented to a hospital less than 6 hours after onset of pain. More than half (64%) of Group 2's cases presented more than 24 hours after pain onset. Fever and pyuria appeared more frequently in Group 2 than in Group 1 and the results reached statistical significance (p = 0.001 and p = 0.044, respectively). Group 1 had more testicular tenderness than Group 2 (p <0.001). Our testicular salvage rate was 59.7%, and 40.3% of patients underwent orchiectomy.ConclusionsCDUS predicted the diagnosis of TT (sensitivity 98.6%). Furthermore, clinical findings may also play a substantial role in the differential diagnosis of acute scrotum.