Objective: To evaluate the diagnostic value of serum inflammation markers derived from complete blood count in diagnosis of prostate cancer (PCa). Methods: We retrospectively analyzed the data of 621 patients who underwent prostate biopsy between March 2013 and April 2018. Age, prostate specific antigen (PSA), free PSA, platelet count, neutrophil count, lymphocyte count, monocyte count, prostate volume (PV) and pathology result of the patients were recorded. Patients were grouped as benign prostatic hyperplasia (BPH), prostatitis and PCa. Patients were also grouped according to PSA values, as PSA < 4 , PSA 4-10 and PSA > 10 ng/dl. Results: The mean lymphocyte-to-monocyte ratio (LMR) value of the patients with PCa was significantly lower in the entire cohort (p = 0.047). In the PSA 4-10 ng/dl range, LMR value wassignificantly lower in patients with PCa than those with BPH or prostatitis (p = 0.012). In this PSA range, free/total PSA ratio and LMR were significant factors to predict PCa. The cut-off values of LMR, free/total PSA were 3.05 and 0.15 respectively. The sensitivities, spesificities, positive predictive values (PPV) and negative predictive values using LMR cut-off, free/total PSA cut-off and their combination were assessed. Specificity and PPV of the combination group were higher (97.2%, 83.3% respectively) compared to free/total PSA cut-off group (91.6%, 76.6%) and LMR cut-off group (67.8%, 43.7%).Conclusions: LMR is a useful tool at detecting PCa especially in patients with PSA value between 4 and 10 ng/dl. The combination of free/total PSA ratio and LMR improves the diagnostic accuracy more than the use of free/total PSA ratio alone.

No abstract

To compare the efficacy of the middle calyx access (MCA) and lower calyx access (LCA) in the treatment of lower pole kidney stones. Materials and Methods: The data of patients with isolated lower pole kidney stones who underwent percutaneous nephrolithotomy via MCA or LCA between 2009 and 2019 were evaluated retrospectively. Pre-, peri-, and postoperative parameters of the groups (LCA group and MCA group) were compared. A value of p < 0.05 was considered significant. Results: A total of 601 patients with lower pole kidney stones were included in the study. LCA was performed for the initial tract in 400 patients, and MCA was performed in 201 patients. There were no significant differences in terms of age, gender, laterality, body mass index, previous operation history, stone burden, duration of fluoroscopy, and stone-free rate between the groups. Operation time was significantly longer in the LCA group (p = 0.041). In the LCA group, additional access was required in 50 cases, which was significantly higher than in the MCA group (p = 0.013). Clinically insignificant residual fragments (CIRF) were present in 28 patients (7%) in the first group (sig-nificantly higher vs. MCA: p = 0.044). There were no statistically significant differences in terms of overall complication and transfusion rates. Conclusions: MCA had superior outcomes in terms of operation time, CIRF rate, hemoglobin drop, and requirement of an additional tract compared to LCA. Further studies evaluating the efficacy of MCA in lower pole kidney stones should be performed to verify our results.

Objective: In the management of benign prostatic hyperplasia (BPH), urology guide- lines recommend medical or surgical treatments according to different prostate volumes (PV). The aim of this study was to analyze the relationships between PV and age, total and free prostate specific antigen (tPSA, fPSA) and fPSA/tPSA ratio in patients without histologically proven prostate cancer. Materials and methods: A retrospective analysis was made of the data of 1334 patients who underwent transrectal ultra- sound (TRUS)-guided prostate biopsy between January 2016 and October 2018. A total of 438 patients with available data for age, tPSA and fPSA levels and PV calculated by TRUS were enrolled in the study. Patients with chronic prostatitis pathology in addition to BPH were also noted and evaluated as a separate group. Results: There were significant correlations between PV and age, tPSA, fPSA, fPSA/tPSA ratio (r = 0.210, r = 0.338, r = 0.548, r = 0.363 respectively). In multivariate linear regression analysis, fPSA was found to be the only predictor for PV (p < 0.001) when compared to age (p = 0.097), tPSA (p = 0.979) and fPSA/tPSA ratio (p = 0.425). In patients with chronic prostatitis pathology there were significant correla- tions between PV and age, tPSA, fPSA, fPSA/tPSA ratio (r = 0.279, r = 0.379, r = 0.592, r = 0.359, respectively). The multivariate linear regression analysis showed a signifi- cant correlation only between PV and tPSA and fPSA/tPSA ratio but not with fPSA and age (p = 0.008, p = 0.015, p = 0.430, p = 0.484, respectively). In men with only BPH pathology there were significant correlations between PV and age, tPSA, fPSA, fPSA/tPSA ratio (r = 0.223, r = 0.385, r = 0.520, r = 0.287, respectively) In multivariate linear regression model the significant correlation was shown only between PV and fPSA (p < 0.001). Conclusions: Although tPSA was significantly correlated with PV in patients without prostate cancer, the correlation between fPSA and PV was much stronger. However, it should be kept in mind that the efficacy of fPSA may be limited in patients with clinically unknown prostatic inflammation.

No abstract

To evaluate the efficacy of the non-contrast-enhanced computed tomography (NCECT) renal pelvis Hounsfield unit (HU) values in differentiating between the hydronephrosis and pyonephrosis in dilated urinary systems. Materials and methods Patients who underwent percutaneous nephrostomy (PN) due to urinary system obstruction in the last three years were retrospectively evaluated. Pyonephrosis and hydronephrosis groups were differentiated according to the clarity of percutaneous needle aspiration. The patients' renal pelvic anteroposterior (AP) diameter, renal pelvic area, and mean HU values were measured on NCECT and compared between two groups. Results PN was performed on a total of 523 patients. The study included 159 patients and 214 renal units. Hydronephrosis was detected in 176 renal units and pyonephrosis in 38 renal units. No statistically significant difference was observed between the measured AP diameter and renal pelvic area in the two groups (28.45 ± 10.1 mm vs. 31.13 ± 14.4 mm, p = 0.36 and 658.51 ± 433.1 mm 2 vs. 755.14 ± 470.6 mm 2 , p = 0.22, respectively). The mean HU value of the pyonephrosis group was significantly higher (2.30 ± 5.02 vs. 10.97 ± 6.68, p < 0.001). At the cutoff value of 8.46, HU had a sensitivity of 68.4% and specificity of 92.6% in the diagnosis of pyonephrosis. Conclusions It is possible to determine differential diagnosis between pyonephrosis and hydronephrosis easily and without additional cost by performing dilated renal pelvis HU measurements on NCECT.

Tıkayıcı uyku apne sendromlu olgularda uyku MRG ve uyku endoskopisi bulgularının karşılaştırılması Comparison of sleep mri and sleep endoscopy findings in patients with obstructive sleep apnea syndrome Amaç: Çalışmamızın amacı tıkayıcı uyku apne sendrom (TUAS) lu hastalarda üst solunum yolunda ki tıkayıcı patolojilerin değerlendirilmesine yönelik olarak geliştirilmiş olan iki yöntemin; uyku endoskopisi (UE) ve uyku magnetik rezonans görüntüleme (MRG) bulgularının değerlendirilmesi ve karşılaştırılmasıdır. Gereç ve Yöntem: Çalışmaya TUAS tanısı olan (AHI>5) toplam 20 hasta dahil edildi. Hastaların uyku ve uyanıklık halinde MRG ile uvulopalatal bölge, retropalatal bölge ve dil kökü seviyesinde anteroposterior (A-P) çap ve yüzey alan ölçümleri yapıldı. Uyku ve uyanıklık halinde yapılan ölçüm ortalamaları karşılaştırıldı.Bu hastalara ayrıca ameliyathane şartlarında uyku endoskopisi (UE) uygulanarak uvulopalatal,lateral farengeal ve dil kökü bölgesinde tıkanıklık düzeyi yüzde üzerinden değerlendirildi.Elde edilen verilerin korelasyonu istatiksel yöntemlerle değerlendirildi. Bulgular: Uyku MRG değerlendirilmesinde her üç bölgede de uyanık pozisyonda yapılan ölçümlere göre istatiksel olarak anlamlı azalma görüldü (p<0.001). UE ile uvulopalatal ve dil kökü düzeyinde %50 ve üzeri tıkanıklık gözlenen hastaların, çap ve yüzey ölçüm alanları ortalaması %50'den az tıkanıklık saptanan hastalara göre istatiksel olarak anlamlı düzeyde daha düşüktü (p<0.05). Bu nedenle UE ve Uyku MRG yöntemlerinin verileri birbiri ile uyumlu olarak yorumlandı (p<0.05). Sonuç: UE bulgularının daha objektif bir teknik olan Uyku MRG bulguları ile uyumlu olması, UE 'nin etkinliğini göstermesi açısından önem taşımaktadır. Bununla birlikte UE daha az ekipmanla uygulanabilmekte ve operasyon öncesi tıkanıklığa yol açan bölgenin direk görüntülemesine imkan tanımaktadır. Anahtar Sözcükler: Horlama; MRG; polisomnografi; uyku apnesi; uyku endoskopisi. Introduction: this study we aimed to compare the findings of two methods which developed for the diagnosis of obstructive pathology in patients with obstructive sleep apnea syndrome (OSAS); sleep endoscopy and dynamic sleep magnetic resonance imaging (MRI). Methods: A total of 20 patients with OSAS (AHI>5) were included in the study. Anteroposterior (A-P) diameter and surface area measurements of uvulopalatal region, retropalatal region and tongue root were performed by MRI in sleep and wakefulness. The mean measurement of sleep and wakefulness were compared. In these patients, sleep endoscopy (UE) was performed under operating room conditions. The correlation of the obtained data was evaluated by statistical methods. Results: There was a statistically significant decrease in sleep MRI evaluation in all three regions compared to measurements in awake position (p<0.001). The mean diameter and surface area of the patients with UE occured at 50% or more at the level of uvulopalatal and tongue root were statistically significantly lower than those with less than 50% obstruction (p<0.05). Therefore, UE and Sleep MRI...

Introduction: We aimed to identify factors affecting percutaneous nephrolithotomy (PNL) outcomes among patients with horseshoe kidney (HSK) and assess the predictive accuracy of the Clinical Research Office of the Endourological Society (CROES), Guy’s Stone Score (GSS), and S.T.O.N.E. scoring systems. Methods: Data from 98 patients with HSK who underwent PNL between November 2010 and January 2020 were evaluated. Patients were divided into the stone-free (SF) and non-SF groups and compared according to demographic data, stone and surgical characteristics, and stone scoring systems. Multivariate logistic regression analysis was performed to identify factors associated with SF status. Results: Among the included patients, 87 were male and 11 were female (mean age: 47.37 ± 14.42 years). The SF rate was 84.7% (83 patients). Group analysis identified GSS (p < 0.001), CROES score (p < 0.001), S.T.O.N.E. score (p = 0.014), stone burden (p = 0.045), and multiplicity (p < 0.001) as factors associated with SF status. Among our cohort, 10 patients developed complications. All scoring systems were significantly correlated with SF status (CROES: r = −0.442, p < 0.001; GSS: r = 0.442, p < 0.001; S.T.O.N.E.: r = 0.250, p = 0.013), while CROES score was identified as an independent factor associated with SF status (95% CI: 0.937–0.987; p = 0.003). Conclusions: PNL is an effective method for treating nephrolithiasis among patients with HSK. Moreover, stone-related factors, such as larger size, multiplicity, and complexity, were associated with procedural failure. Finally, the CROES nomogram was a better predictor of SF status compared with other scoring systems.