Regarding the cosmetic side effects and hyperlipidemia, tacrolimus was found to be superior to cyclosporine A. Where hyperlipidemia is considered to be a risk factor for cardiovascular disease, tacrolimus use should be considered as a more acceptable treatment modality. However, the immunosuppressive regimen should be evaluated individually.

The goals of this study were to examine cases of proximal ureteral stones in which semirigid or flexible ureteroscopes alone were insufficient for endoscopic treatment, requiring the combination of both. A total of 137 patients were retrospectively evaluated. Holmium laser was used as the energy source for stone fragmentation. Each operation was begun with a 6/7.5 Fr semirigid ureteroscope (URS), and continued with a 7.5 Fr flexible URS in those procedures that failed to reach the stone or push-up. Double J stents were inserted into those patients in whom the flexible URS failed. Shock wave lithotripsy (SWL) or a repeat ureteroscopy (after 2–4 weeks) was planned in those patients who were considered to be treated unsuccessfully. The demographic features of the patients, stone sizes, treatment outcomes, need for additional treatment, complications, and the results of the postoperative 1-month early follow-up were evaluated. The mean age of the patients (77 males and 60 females) was 38 ± 6.7 years old, the mean stone size was 12.3 ± 3.7 mm, and the number of patients with persistent hydronephrosis was 86 (62.8 %). A stone-free diagnosis was achieved in a total of 124 patients (90.5 %), using a semirigid URS in 80 patients and a flexible URS in 44 patients. Treatment using a flexible URS was administered in 38 patients (27.7 %) due to push-up, and in 6 patients (4.3 %) because of the failure to advance the semirigid URS into the ureter. The treatment failed in 13 patients (9.4 %) despite the use of both methods. Treatment using low-caliber semirigid ureteroscopy and a holmium laser is possible, regardless of the stone size, in female patients without hydronephrosis. However, the need for combined treatment with flexible ureteroscopy is increased in male patients with hydronephrosis.

Introduction: The incidence of multifocality and associated clinicopathological factors in renal cell carcinoma were evaluated. Materials and Methods: Clinicopathological characteristics were assessed for 122 renal cell carcinoma-pathological specimens from 121 patients. Microscopic and gross tumor pathology, incidence of multifocality as well as association between tumor grade, histological subtype, stage, size and vascular involvement were assessed. Results: Multifocal renal cell carcinoma was diagnosed in 16 of 122 specimens (13.1%). Satellite lesions for 15 of 16 specimens displaying mulifocality had the same histological subtype as their primary tumor. The occult multifocality rate was 11.4%. Tumor grade and stage, but not size or volume, histological subtype, and vascular involvement were significantly related to multifocality. Conclusions: Accurate staging of renal cell carcinoma appears to be essential in determining whether a patient should undergo nephron-sparing surgery or radical nephrectomy. Patients with high stage and grade should receive the highest attention after nephron-sparing surgery. Larger studies are needed to further elucidate the association between clinicopathological factors and multifocality.

Paratesticular fibrous pseudotumors (PFPs) are rare pathologies with quite wide and variable topographic-morphological features. It is difficult to distinguish PFPs from malignant masses. Treatment can be done by resection of the mass. We reported a young patient’s findings about this rare pathology.

Objective: Our aim was to determine the general knowledge and awareness levels, information sources, and the state of medical check-up for prostate cancer (PCa) and relevant effective factors. Material and methods:The participants were asked to answer to 14 questions of a questionnaire about age, education, economic and social condition, knowledge about PCa, state of being examined and their related factors. According to demographic characteristics of the participants, levels of awareness about PCa, sources of information, affecting factors and their interrelationships were examined. Two groups were formed according to age (<60 years, >60 years) and variations according to ages were investigated.Results: Two hundred and ninety-three men with an average age of 57 years (range 40-85) were included in the study. Our findings showed that 68.3% of the participants were thinking that PCa is a frequently seen disease, 88.4% were thinking that it can be treated and 62.8% of men specified that their information sources are doctors. We also found that 60.8% of the participants had not undergone prostate examination and prostate specific antigen (PSA) control. The most reason for not having annual examinations was (44.4%) "negligence". Significantly greater number of men with higher education (high school/university) were highly informed about PCa (p=0.037). Check-up rates were statistically significantly higher among men with intermediate income (p=0.041). Curability of PCa diagnosed at an early stage was acknowledged by statistically higher number of individuals under the age 60 (p<0.05). Health control, prostate examination and/or PSA control rates were higher in men with a family history of PCa and in the group of >60 years. Conclusion:Although PCa has a high prevalence and mortality rates, personal and social information and sensitivity levels must be increased as it can be treated if diagnosed at an early stage. We think that social and medical impact of the disease can be decreased with the planning of effective methods based on sociocultural and economic factors.

Objective: The prevalence of stone diseases is high in Turkey. Thanks to the technological improvements and to the increase in the number of qualified and experienced specialists in the last thirty years, there has been an increase in the application of minimally invasive methods in the stone disease surgery. This study, with a sample survey of Western Black Sea region, aims at revealing the changes and improvements in the treatment of stone diseases in different centers in Anatolia within the last ten years. Material and methods:Six centers in 4 of the provinces of the Western Black Sea Region were selected and the patients' files were retrospectively analyzed. The treatment methods that were recommended for and/or applied to the patients diagnosed with urinary stone diseases were recorded by years. The urinary stone diseases were divided into three separate groups; kidney, ureters and bladder. Treatment options were recorded into categories as open surgery, percutaneous nephrolithotripsy, retrograde intrarenal surgery, semirigid ureterorenoscopy, flexible ureterorenoscopy, and ESWL.Results: A total of 26044 patients with stone diseases have been treated in the above-mentioned centers for the last 10 years. The distributions of the stone diseases in relation to their localization were as follows: -kidney stones: 9040 (34.7%), ureter stones: 15264 (58.6%), and bladder stones: 1740 (6.7%). As for the distribution of the treatment in relation to the treatment methods, it was seen that open surgery for 1032 (4%) patients, endoscopic surgery for 15038 (58%) patients, and ESWL for 9974 (38%) patients had been applied. While URS and PCNL are currently the commonly used treatment methods in the Western Black Sea Region, RIRS has begun to be used in a limited number of patients for the last 3 years. Conclusion:Though being a little late, the advances in endrourology offer practical applications in the Western Black Sea region as well. Although this study suggests implications for the evaluating of the periphery outcomes of the improvements in stone disease treatments, for the planning of training schemes, and for equipment planning, further research based on more data from more centers is needed to have a nation-wide perspective.