Purpose Our aim was to evaluate the prognostic implications of a preoperative novel index, systemic immune inflammation index (SII) in patients undergoing surgery due to renal cell carcinoma. Methods A retrospective analysis of 176 patients who underwent radical nephrectomy and diagnosed with RCC was carried out. Systemic immune inflammation index, which is calculated by neutrophil x platelet/lymphocyte, and other inflammation indexes such as neutrophil/lymphocyte ratio, platelet/lymphocyte were included. The Kaplan-Meier analysis was plotted, and the groups were compared using a log-rank test. The ROC curve for the aforementioned inflammation indexes was plotted. Results SII (× 109/l) for lower and higher T stage group were 743.70 ± 587.55 and 907.06 ± 631.96, respectively, which is statistically significant (p = 0.01). Patients with higher Fuhrman grade (G3 and G4) were found to have higher SII (p = 0.001). SII 830 was demonstrated as the best cutoff value for overall survival. The optimal cutoff point for SII was defined as 850 for disease-specific survival. High SII scores were associated with poor overall survival in RCC patients (p = 0.034). However, no significant association was found for disease-specific survival (p = 0.29). Conclusions Systemic immune inflammation index was found to be associated with increased TNM stage and poor prognosis of RCC patients udergoing radical nephrectomy.

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Aim: There is a large body of evidence of clinical studies regarding the relation between metabolic syndrome (MetS) and benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS) in men. A possible link between inflammation and these 2 clinical entities has also been proposed. Here, we aimed at evaluating the role of neutrophil-lymphocyte ratio (NLR), an indicator of inflammation and MetS, in the pathogenesis of LUTS and other BPH-related parameters. Method: We evaluated 244 patients with benign prostate hyperplasia admitted to our outpatient clinic between January 2014 and June 2015. NLR was calculated from the peripheral blood sample for all patients. Patients' anthropometric characteristics, serum lipid levels, waist circumferences, total prostate-specific antigen (PSA) and testosterone values, prostate volumes, max values and International Prostate Symptom Score (IPSS) were recorded. All statistical analyses were conducted by SPSS version 17.0 package program, and p value <0.05 was chosen as the criterion for statistical significance. Results: There was statistical significance between NLR and patients with severe IPSS score (>20) and over age 60 years (p = 0.02). Patients younger than 60 years had statistical significance between NLR and PSA <2.5 ng/dl (p = 0.004). When body mass index was selected, there was statistical significance between prostate volume <35 ml (p = 0.009) and age >60 years (p = 0.028). If 60 years of age was selected as cut-off value, there is statistical significance between age and severe IPSS, and in terms of mild erectile dysfunction, PSA >2.5 ng/dl, and prostate volume >35 ml. Conclusion: We found positive correlation between NLR and severe symptoms and progression of BPH. In this manner, anti-inflammatory therapy could contribute to the medical treatment of BPH. Higher NLR may be a candidate marker for severity of symptoms in BPH patients.

IntroductionTransurethral resection (TUR) is the most common surgical technique for the diagnosis and initial treatment of bladder cancer. In this study, we evaluated two surgical techniques in terms of bladder injury due to obturator reflex in patients that underwent TUR for non-muscle invasive bladder cancer (NMIBC).Material and methods93 patients who underwent TUR for bladder cancer were analyzed. Fifty patients underwent monopolar resection and 43 patients underwent plasmakinetic resection. Standard TUR were performed with conventional Storz monopolar resection using a U-shaped cutting loop, 120V cutting/80 V coagulation settings, 5% mannitol fluid was used for irrigation. For bipolar resection, an Olympus ESG-400 plasmakinetic loop bipolar device using a U-shaped cutting loop, 160V cutting/80V coagulation settings and normal saline for irrigation was used.ResultsIn the monopolar resection group; obturator reflex was seen in 4 (8%) patients. Bladder perforation caused by the obturator reflex was seen in 4 (8%) patients, but hemorrhage and other major complications were not seen in this group. In the bipolar resection group; obturator reflex was seen in 15 (34%) patients. Bladder perforation caused by the obturator reflex was seen in 10 (23%) patients.ConclusionsBipolar transurethral resection of bladder tumor was not superior to monopolar resection with respect to obturator reflex and bladder perforation. We conclude that we do not yet have enough experience concerning the long-term complications and major complications associated with bipolar resection of bladder cancer.