Ekrem Islamoglu

Objective: This multicenter study aimed to evaluate postoperative partner education practices among Turkish urologists performing penile prosthesis implantation (PPI) and to assess their attitudes toward combined device training and sexual counseling. Material and Methods: A cross-sectional electronic survey was distributed to 164 urologists across the seven geographical regions of Türkiye, with 84 responses obtained (response rate: 51.2%). The 10-item questionnaire assessed: (i) demographic and procedural characteristics, (ii) current partner education practices, and (iii) discrepancies between beliefs and practices (using 5-point Likert scales). Results: The mean professional experience was 16 years (range: 2–35 years). Significant belief–practice gaps were identified: Device training was considered necessary by 81% of respondents but implemented by only 31% (50.6-point gap), while sexual counseling was considered necessary by 83% but implemented by only 19% (64-point gap). Significant associations were observed for device training (OR = 2.1) and sexual counseling (OR = 3.4). Senior surgeons (>10 years of experience) were 3.2 times more likely to prioritize partner education (OR = 3.2, 95% CI: 1.8–5.7). Conclusion: Although 72% of urologists endorsed partner education as “essential” substantial barriers to implementation remain. Particularly in sexual counseling, only 15% had received formal training. Institutional protocols and standardized training programs are urgently needed to bridge these gaps in postoperative PPI care.

Background: Urothelial carcinoma of the bladder (UCB) demonstrates considerable heterogeneity, with markedly varying outcomes between non–muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). The pan-immune-inflammation value (PIV), derived from routine hematological parameters, has emerged as a novel biomarker reflecting systemic inflammation and immune dysregulation. This pilot, exploratory analysis evaluated the prognostic relevance of the PIV in UCB and contextualized PIV against other inflammation-based indices. Methods: We retrospectively analyzed 119 patients with histologically confirmed UCB who were treated between 2019 and 2024. PIV was calculated as (neutrophils × platelets × monocytes) ÷ lymphocytes. Additional indices included the NLR, SII, SIRI, and PLR. Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan–Meier analysis, and prognostic factors were assessed using Cox regression. Results: Among 119 patients (median age, 72 years; 88% male), 68 were diagnosed with NMIBC and 51 with MIBC. Elevated PIV levels were significantly associated with NMIBC progression to MIBC (p = 0.028) and strongly correlated with NLR, SII, SIRI, and PLR. Patients with high PIV exhibited shorter OS (24 vs. 45 months) and PFS (20 vs. 35 months) than those with low patients (p < 0.001). Although the prognostic value was evident in the univariate analyses, PIV did not retain significance in multivariate models. Conclusion: Elevated PIV levels predict adverse survival outcomes and progression in UCB, underscoring its potential as a cost-effective and accessible biomarker for risk stratification. Prospective validation in larger cohorts is warranted to confirm its role in personalized patient management.

Aim: Targeted prostate biopsies using magnetic resonance imaging (MRI) have gained prominence for early detection. We compared cognitive fusion biopsy, the most practical of these biopsy methods, with systematic prostate biopsy performed under transrectal ultrasonography (TRUS). Methods: Between August 2021 and August 2022, 81 patients who had never undergone prostate biopsy or surgery, with total prostate-specific antigen (PSA) levels between 4 and 20 ng/mL, and had lesions scoring 3 or above on the Prostate Imaging Reporting and Data System (PIRADS) on multiparametric MRI (Mp-MRI), were included in the study. Of these patients, 39 underwent standard TRUS-guided systematic prostate biopsy, while 42 underwent cognitive fusion biopsy (systematic + targeted). Results: The ages, PSA levels, and prostate volumes of the patients included in the study were compared, and no significant differences were found between the groups. The prostate cancer detection rate was 41% in the systematic biopsy group and 52.4% in the cognitive fusion biopsy group, but this difference was not statistically significant ( p = 0.306). The detection rate of clinically significant prostate cancer was 25% in the systematic biopsy group and 63.6% in the cognitive fusion biopsy group, with this difference being statistically significant ( p = 0.019). In the cognitive fusion biopsy group, 36.4% of patients with malignant biopsy results had no tumour at the targeted site, while 63.6% had tumours detected at the targeted site ( p = 0.286). Conclusion: Cognitive fusion biopsy was found to be superior to standard TRUS-guided systematic prostate biopsy in diagnosing clinically significant prostate cancer. However, there was no difference between the two biopsy techniques in overall prostate cancer detection. Level of evidence: Not applicable

Objective: This study aims to evaluate the effectiveness, safety, and patient tolerance of penile prosthesis implantation (PPI) performed under local anesthesia (LA). The study investigates its impact on perioperative pain management, postoperative recovery, and overall patient satisfaction. Material and Methods: This prospective study included 26 male patients who underwent PPI under LA between January 2024 and December 2024. Ethical approval was obtained from the Ethics Committee Antalya Training and Research Hospital No: 2/24, Date: 30.01.2025). Pain intensity was assessed using the Visual Analog Scale (VAS), while patient stability and intraoperative parameters were monitored. The American Society of Anesthesiologists (ASA) classification system was used for anesthesia risk assessment. Results: The mean age of the patients was 67.25 ± 11.48 years. Diabetes mellitus and hypertension were present in 75% and 62.5% of patients, respectively. According to ASA classification, 46.2% were classified as ASA-II, while 53.8% were ASA-III. The mean intraoperative VAS score was 1.8 (mild pain), while the mean postoperative VAS score was 4.6 (mild-to-moderate pain). No patients required additional sedation or conversion to general anesthesia. No major intraoperative complications or postoperative prosthesis-related complications were observed. Conclusion: Local anesthesia is a feasible and effective alternative for penile prosthesis implantation, offering benefits such as minimal intraoperative discomfort, avoidance of systemic anesthetic complications, and a favorable recovery profile. Further studies with larger cohorts are needed to optimize pain management strategies and evaluate long-term functional outcomes.

OBJECTIVE: In this study, we aimed to investigate the factors affecting spontaneous stone passing in patients who received medical expulsive therapy due to distal ureteral stones. MATERIAL AND METHODS: From September 2022 to October 2023, a total of 148 patients with distal ureteral stones sized 4-10 mm were included. Patients received silodosin 4 mg as medical expulsive therapy and were followed up for a maximum of four weeks. The patient- and stone-related variables affecting spontaneous stone passage were evaluated. RESULTS: The mean age of the participants was 42.92±12.78 years. The stone expulsion rate was 64.2%. The rate of spontaneous stone passage was significantly higher in patients with lower stone size, stone burden, ureteral wall thickness, distance of the stone to the ureterovesical junction, neutrophil-lymphocyte ratio and hydronephrosis grade. (all, p<0.05). The distance of the stone to the ureterovesical junction, ureteral wall thickness, and neutrophil-to-lymphocyte ratio were independent predictors of spontaneous passage (p:0.036, p:0.001, p:0.001, respectively). CONCLUSIONS: The distance of stone to the ureterovesical junction, ureteral wall thickness, and neutrophil-to-lymphocyte ratio can be useful parameters to estimate spontaneous stone expulsion. These factors play important roles in decision-making for the management of distal ureteral stones.

Objective: The aim of this study is to determine whether there is a genetic predisposition in young patients with transitional cell carcinoma (TCC) of the bladder. Material And Methods: Data were collected from a total of 652 patients who underwent transurethral resection of bladder tumor (TUR-BT) between January 2010 and January 2021. Seven patients under the age of 40, non-smokers, and without occupational predisposing factors to urinary tract TCC were included in the study. Age, body mass index (BMI), sex, occupation, and five-year follow-up were collected retrospectively. A total of 403 cancer-related genes were analyzed from the patients’ blood samples. The Clinical Exome Sequencing test was used to identify genetic mutations. Results: Six of the patients were male and one patient was female. The mean age and BMI were 31.42 ± 2.12 (22-39) years and 21.72 ± 33.14 (22-27.7) kg/m2, respectively. None of the patients had a first-degree relative with urinary tract TCC. Of all the patients, only one patient had a deletion of exons 1 to 17 in the breakpoint cluster region gene. Conclusion: Genetic predisposing factors in young bladder TCC have not been clearly identified. Although our study included a limited number of patients, our results showed no genetic predisposition in young patients with bladder TCC without family history of bladder cancer. To evaluate the exact relationship, prospective randomised controlled trials with larger numbers of patients are needed.

Purpose: The aim of this study is to investigate the effect of bladder neck plication during transperitoneal robot-assisted radical prostatectomy (tRARP) on orgasm-related incontinence (climacturia) and the relationship between International Index of Erectile Function 5 (IIEF-5) scores and climacturia. Materials and Methods: We evaluated 118 patients who underwent nerve-sparing tRARP in our clinic and survived the first postoperative year. Patients were divided into two groups: those who underwent bladder neck plication (Group 1, n = 58) and those who did not (Group 2, n = 60). Our study investigated whether there is a difference between the groups in terms of climacturia or if there is a relationship between IIEF-5 scores and climacturia. Results: Of the patients in Group 1, 10.3% had incontinence and 13.8% had climacturia. Of the patients in Group 2 who did not have bladder neck plication, 10% had incontinence and 15% had climacturia. There was no difference between the groups in terms of climacturia (P > .825). Three patients (5.2%) in Group 1 and four patients (6.6%) in Group 2 requested treatment. There was no statistically significant correlation between IIEF-5 scores and climacturia in both groups (Group 1, P > .208; and Group 2, P > .508). Conclusions: In our study, the frequency of climacturia in patients who underwent bladder neck plication during tRARP was consistent with the literature and did not show a statistically significant difference from patients who did not undergo bladder neck plication. It has been observed that bladder neck plication, which has no effect on long-term continence, does not contribute to prevention of climacturia. No correlation was found between IIEF-5 scores and climacturia.

Akademisyen Yayınevi yöneticileri, yaklaşık 30 yıllık yayın tecrübesini, kendi tüzel kişiliklerine aktararak uzun zamandan beri, ticarî faaliyetlerini sürdürmektedir. Anılan süre içinde, başta sağlık ve sosyal bilimler, kültürel ve sanatsal konular dahil 1000 kitabı yayımlamanın gururu içindedir. Uluslararası yayınevi olmanın alt yapısını tamamlayan Akademisyen, Türkçe ve yabancı dillerde yayın yapmanın yanında, küresel bir marka yaratmanın peşindedir. Bilimsel ve düşünsel çalışmaların kalıcı belgeleri sayılan kitaplar, bilgi kayıt ortamı olarak yüzlerce yılın tanıklarıdır. Matbaanın icadıyla varoluşunu sağlam temellere oturtan kitabın geleceği, her ne kadar yeni buluşların yörüngesine taşınmış olsa da, daha uzun süre hayatımızda yer edineceği muhakkaktır.