To predict local invasive disease before retropubic radical prostatectomy (RRP), the correlation of perineural invasion (PNI) on prostate needle biopsy (PNB) and RRP pathology data and the effect of PNI on biochemical recurrence (BR) were researched. For patients with RRP performed between 2005 and 2014, predictive and pathologic prognostic factors were assessed. Initially all and D'Amico intermediate-risk group patients were comparatively assessed in terms of being T2 or T3 stage on RRP pathology, positive or negative for PNI presence on PNB and positive or negative BR situation. Additionally the effect of PNI presence on recurrence-free survival (RFS) rate was investigated. When all patients are investigated, multivariate analysis observed that in T3 patients PSA, PNB Gleason score (GS) and tumor percentage were significantly higher; in PNI positive patients PNB GS, core number and tumor percentage were significantly higher and in BR positive patients PNB PNI positivity and core number were significantly higher compared to T2, PNI negative and BR negative patients, separately (p < 0.05). When D'Amico intermediate-risk patients are evaluated, for T3 patients PSA and PNB tumor percentage; for PNI positive patients PNB core number and tumor percentage; and for BR positive patients PNB PNI positivity were significantly higher compared to T2, PNI negative and BR negative patients, separately (p < 0.05). Mean RFS in the whole patient group was 56.4 ± 4.2 months for PNI positive and 96.1 ± 5.7 months for negative groups. In the intermediate-risk group, mean RFS was 53.7 ± 5.1 months for PNI positive and 100.3 ± 7.7 months for negative groups (p < 0.001). PNI positivity on PNB was shown to be an important predictive factor for increased T3 disease and BR rates and reduced RFS.
Objective
To present a nation‐wide analysis of the workload of urology departments in Turkey week‐by‐week during Covid‐19 pandemic.
Methodology
The centers participating in the study were divided into three groups as tertiary referral centers, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9‐March‐2020 and 31‐May‐2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated; also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019.
Results
A total of 51 centers participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the third week of pandemics in state hospitals and tertiary referral centers; however the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared; a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid‐19 pandemic compared to normal life.
Conclusions
Covid‐19 pandemic significantly effected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non‐deferrable surgeries by urologists in concordance with published clinical guidelines.
Amaç: Distal üreter taşlarında, preoperatif kontrastsız bilgisayarlı tomografi (BT) bulgularının ve peroperatif lazer prob seçiminin toplam lazer süresi, enerji düzeyi ve üreterorenoskopi (URS) zamanı üzerine etkisini araştırmayı amaçladık. Objective: To investigate the effect of preoperative non-contrast computed tomography (NCCT) findings and peroperative laser probe selection on total laser time, energy level and ureterorenoscopy (URS) time for distal ureteral stones. Materials and Methods: We prospectively evaluated 72 patients with single distal ureteral stone measuring 5-25 mm in diameter on NCCT, who were treated with ureteroscopic lithotripsy (URSL) between June 2015 and October 2016. The patients were divided into two groups according to probe selection as 365 µm and 550 µm groups. Stone diameters, stone volume and Hounsfield units (HU) measured on NCCT, and URSL findings were noted at the end of the treatment. These findings were compared between the groups. Also the possible predictive value of NCCT findings was evaluated for URSL data. Results: There were 17 patients in the 365 µm and 55 patients in the 550 µm groups. There was no significant difference in URSL success rate and other predictive data between the groups. However, among the peroperative data, laser time, laser energy level and laser energy/time ratio were significantly lower in the 365 µm group compared to the 550 µm group (p<0.05). Correlation analysis indicated that total laser time and URS time were correlated with stone diameter, stone volume, HU values and density (HD). Laser energy level was only correlated with longitudinal stone diameter and HD. Conclusion: Stone diameter, volume and HU values are significant predictors of laser energy level, URS and laser time for distal ureteral stones. Also, use of a thinner probe decreases total laser time, laser energy level and laser energy/time ratio. In addition, thinner laser probe shortens URS time.
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