Mustafa Kadihasanoglu

Introduction: Male genital emergencies involving the penis are uncommon and necessitate immediate medical attention as well as surgery. The term “priapism” refers to a persistent erection caused by malfunctioning mechanisms that control rigidity, flaccidity, and penile tumescence. Identification of the underlying hemodynamics is necessary for a prompt and accurate diagnosis of priapism. Objectives: To discuss the epidemiology, pathophysiology, and classification of priapism, as well as to give healthcare professionals up-to-date clinical evidence on the management of the priapism. Methods: The members of the Fifth International Consultation for Sexual Medicine (ICSM) Committee 22 have conducted a review of the peer-reviewed scientific literature to present an objective, comprehensive analysis regarding the diagnosis and management of priapism. This report reviews the literature from 2010 to 2025 on priapism and concentrates on guidelines that have been written in the last ten years. Every relevant article was examined critically and discussed. Results: This manuscript provides evidence-based diagnostic and treatment recommendations for ischemic, non-ischemic, recurrent ischemic priapism, and priapism in patients with sickle cell disease. The role of imaging, laboratory testing, early urologists’ involvement when a patient presents to the emergency room, the discussion of conservative therapies, improved data for patient counseling regarding the risks of erectile dysfunction and surgical complications, specific recommendations regarding intra-cavernosal phenylephrine with or without irrigation, the inclusion of novel surgical techniques, and early penile prosthesis placement are all covered in this recommendation. Conclusion: Every patient with priapism should have an emergency evaluation to determine whether they have acute ischemic or non-ischemic priapism, and those who have experienced an acute ischemic event should receive early intervention when necessary. Treatment for NIP must be based on the goals of the patient, the resources at hand, and the experience of the clinician; it is not an emergency.

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Study demonstrated that antibiotic resistance in the treatment of uncomplicated urinary tract infections varies by geographical region. We believe this comprehensive, national prospective study will provide valuable insights for clinicians planning empirical treatment for uncomplicated urinary tract infections.

Objectives: To evaluate the possible association between androgenic alopecia (AGA) and lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH).Methods: A total of 148 patients aged over 45 with LUTS secondary to BPH were prospectively enrolled in this study. According to the Norwood–Hamilton classification, the patients were divided into two groups: AGA (n = 69) and non‐AGA (n = 79). In addition, the cases of AGA were categorized as vertex (n = 39) and frontal baldness (n = 30). The International Prostate Symptom Score (IPSS), uroflowmetry parameters, prostate volume, serum total testosterone (TT), and free and total prostate‐specific antigen concentrations of all patients were assessed and compared between the groups. Correlations between the AGA grade and other variables were also investigated.Results: The serum TT level (354 ± 97.1 vs. 308.6 ± 73.1 ng/dL, p = 0.01), total IPSS (16.1 ± 8.1 vs. 13.4 ± 7.7, p = 0.04), IPSS storage subscore (IPSS‐S) (7.1 ± 3.5 vs. 5.8 ± 3.6, p = 0.03), and number of nocturia episodes (2.5 ± 1.4 vs. 1.8 ± 1.4, p < 0.01) were significantly higher in the AGA group than in the non‐AGA group. There were no significant differences in any of the parameters between the patients with vertex and frontal baldness. The AGA grade showed a significant positive correlation with the TT level (r = 0.407, p = 0.003), IPSS‐S (r = 0.164, p = 0.04), and number of nocturia episodes (r = 0.203, p = 0.015).Conclusions: This study demonstrated that among patients with LUTS, those with AGA had worse symptoms and higher TT levels compared with those without AGA of similar age. Furthermore, the AGA grade was positively correlated with the TT level and storage symptoms.

Background and objective Bladder cancer (BC) is a common urothelial neoplasm, with non-muscle invasive forms comprising about 75% of cases and generally having better outcomes than muscle-invasive types. Accurate preoperative grading and staging of BC are essential for appropriate treatment planning. This study investigates the efficacy of computerized tomography (CT) in correlating the morphological features of tumors to predict the histopathological grades of BC. Materials and methods This retrospective cohort involved 100 patients diagnosed with non-muscle invasive BC, who underwent transurethral resection of bladder tumor (TUR-BT) between January 2010 and August 2021. CT imaging, utilizing a 128-slice CT scanner, was employed to measure the tumor height (H) and contact length (CL). The study considered morphometric parameters across axial, coronal, and sagittal planes. Statistical analyses were conducted, comparing radiological findings with histopathological evaluations. Tumor grading was determined according to the 2004/2016 WHO classification. Results Among the 100 patients with primary bladder tumors, 15 were female and 85 were male, with a mean age of 65.28 ± 7.11 years. Furthermore, 58 had high-grade bladder tumors, while 42 had low-grade bladder tumors. Across all planes, high-grade tumors exhibited higher values for the tumor H, CL, and the tumor height-to-contact length (H/CL) ratio compared to low-grade tumors (p<0.05). Notably, the specificity, sensitivity, and diagnostic accuracy of the tumor CL were higher than those of the tumor H and the tumor H/CL ratio. A tumor CL exceeding 19.1mm measured in the axial plane demonstrated 83% sensitivity and specificity for high-grade tumors. Conclusion The measured CL of the tumor in the axial plane on computerized tomography urography has high sensitivity and specificity in detecting high-grade tumors.