Sinan Çelen

Background: Preservation of sexual function has become a central goal in the surgical management of benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS), yet the impact of treatment on the patient’s partner has rarely been examined. Transperineal laser ablation (TPLA) is an emerging, explicitly ejaculation-sparing technique with a favorable reported sexual function profile. Objective: In this retrospective, single-center, single-arm cohort study, we aimed to longitudinally evaluate erectile function, ejaculatory function and bother, and partner sexual function from the first postoperative week to 12 months after TPLA. Materials and Methods: This retrospective study was based on prospectively collected outcome data from 36 consecutive sexually active men who underwent ultrasound-guided TPLA (SoracteLite™/EchoLaser™) for moderate-to-severe LUTS/BPH, with assessments at postoperative weeks 1 and 2 and months 1, 3, 6, 9, and 12. Erectile function (IIEF-5), ejaculatory function and bother (MSHQ-EjD), and partner sexual function (Female Sexual Function Index, FSFI) were assessed longitudinally alongside IPSS, Qmax, post-void residual volume, and prostate volume. Results: Median baseline IPSS was 31 and prostate volume was 70 mL. IIEF-5 declined transiently at weeks 1 and 2 (both p < 0.001), returned to baseline by month 1, and did not differ significantly from baseline thereafter, consistent with preservation of erectile function. MSHQ-EjD function scores likewise declined transiently in the early postoperative period before rising modestly above baseline from month 3 onward (all p < 0.001, months 3–12), with a parallel change in the bother domain over the same period. Partner FSFI scores followed a similar temporal pattern, declining transiently during the first postoperative month, normalizing by month 3, and was slightly higher than baseline at month 12 (p < 0.05). IPSS improved from 31 to 8 and prostate volume decreased by a median of 52.5% at 12 months (both p < 0.001). No Clavien–Dindo grade ≥II complication occurred. Conclusions: In this retrospective single-arm cohort, TPLA was followed by substantial relief of severe LUTS. The findings are compatible with preservation of erectile function and a small increase in ejaculatory function scores, with partner sexual function following a parallel, non-causal trajectory. In the absence of a comparator group, these later changes cannot be attributed to TPLA itself and may partly reflect urinary symptom relief, medication changes, regression to the mean, or expectation effects. Controlled studies incorporating partner-reported outcomes are needed to determine whether TPLA confers couple-level sexual benefit.

Purpose: To evaluate the efficacy, safety, and tolerability of combined low-intensity extracorporeal shock wave therapy and platelet-rich plasma in patients with acute-phase Peyronie’s disease.Materials and methods: This retrospective single-center study included 42 men with acute-phase Peyronie’s disease treated between January 2025 and January 2026. The acute phase was defined as a symptom duration of less than 6 months. All patients received daily tadalafil, six sessions of low-intensity extracorporeal shock wave therapy, and three intralesional platelet-rich plasma injections. Penile curvature, plaque size, penile pain, and erectile function were assessed before treatment and 3 months after treatment. Penile pain was evaluated with a visual analog scale, and erectile function was assessed using the International Index of Erectile Function. Paired comparisons were performed according to data distribution.Results: The median pain score decreased significantly from 7.00 to 3.50 (p<0.001). Erectile function also improved significantly, with the mean score increasing from 16.59±4.51 to 20.88±5.51 (p<0.001). Mean penile curvature decreased from 33.89±10.49 degrees to 31.53±13.26 degrees, but this change was not significant (p=0.058). Mean plaque size changed from 1.58±0.45 cm to 1.56±0.46 cm without statistical significance (p=0.594). No major adverse events were observed. Minor local complications included mild ecchymosis in 11.9% and transient edema in 4.8% of patients.Conclusion: Combined low-intensity extracorporeal shock wave therapy and platelet-rich plasma appears to be a safe and effective conservative treatment option in acute-phase Peyronie’s disease. The protocol provided significant pain relief and improved erectile function, while stabilizing penile curvature and plaque size

Purpose: This study aimed to investigate the relationship between daily screen exposure duration, symptom severity, and desmopressin treatment success in children with primary monosymptomatic nocturnal enuresis.Materials and methods: A retrospective cohort study was conducted on children aged five years and older diagnosed with primary monosymptomatic nocturnal enuresis between January 2020 and January 2026. Patients were categorized into three groups based on daily screen exposure: 0-1 hour (n=141), 1-2 hours (n=139), and more than 2 hours (n=190). Symptom severity was classified as mild, moderate, or severe based on weekly wet nights. Treatment response to oral desmopressin lyophilisate was evaluated after three months and categorized as complete, partial, or no response.Results: Higher screen exposure was significantly associated with increased symptom severity (p<0.001). In the group with more than 2 hours of exposure, 74.7% of patients had severe symptoms, compared to 39.0% in the 0-1 hour group. Regarding treatment outcomes, desmopressin efficacy decreased as screen time increased (p<0.001). The complete response rate was 36.8% in the 0-1 hour group and 34.8% in the 1-2 hour group but dropped to 20.6% in the group with more than 2 hours of screen exposure. Furthermore, the no-response rate was highest in the group for more than 2 hours at 46.3%.Conclusion: In this study, higher levels of daily screen exposure were associated with greater symptom severity and lower desmopressin response rates in children with primary monosymptomatic nocturnal enuresis. Assessment of screen habits may be considered a component of behavioral urotherapy counseling.

Background: Artificial intelligence (AI) and large language models (LLMs) are increasingly integrated into healthcare, yet their adoption in pediatric urology remains insufficiently explored. Pediatric urology, with its complex and rare conditions, may particularly benefit from AI-based innovations. Objectives: This study aimed to assess pediatric urologists’ awareness, usage patterns, and perceptions regarding AI and LLMs, while also identifying potential applications, barriers, and educational needs. Design: A cross-sectional, descriptive survey was conducted among pediatric urologists. Methods: Between May and July 2025, a 21-item questionnaire was distributed via professional networks and mailing lists. Items addressed demographics, knowledge of AI, frequency and purpose of AI and LLM use, perceived clinical and surgical applications, ethical concerns, and interest in AI training. Descriptive statistics were used for analysis. Results: Of 368 invited pediatric urologists, 103 (28%) responded. Most reported moderate (35.0%) or low (29.1%) knowledge of AI, yet more than half (51.5%) used AI tools daily. LLMs had been used by 96.1% of participants, mainly for scientific writing (78.8%), language editing (54.5%), and text summarization (46.5%). Surgical simulation (46.6%), imaging-based strategy planning (40.8%), and preoperative planning (36.9%) were identified as promising clinical applications. Barriers included lack of trust (52.4%), ethical concerns (43.7%), and insufficient knowledge (35.0%). A strong interest in structured AI training was expressed by 81% of participants. Although responses were obtained from multiple countries, the majority of participants were based in Turkey, and the findings should be interpreted accordingly. Conclusion: Pediatric urologists demonstrate substantial engagement with AI in academic work, while clinical integration is still limited. The findings highlight a strong demand for AI education and emphasize the need for regulatory clarity, ethical frameworks, and validated tools to enable safe and effective use of AI in pediatric urology.

Objectives: Transperineal (TP) prostate biopsy is increasingly used because of its lower complication rates compared with the transrectal approach. However, prospective data regarding its effects on erectile and ejaculatory function remain limited. This study prospectively evaluated short-term sexual function outcomes after TP prostate biopsy in sexually active men. Methods: This single-center prospective observational cohort study included men undergoing TP prostate biopsy between 15 April 2025 and 1 September 2025. Indications for biopsy were prostate-specific antigen levels >4 ng/mL, abnormal digital rectal examination findings, or suspicious lesions (PI-RADS ≥ 3) on multiparametric prostate MRI. Sexual function was assessed at baseline and at 1 and 3 months after biopsy using the International Index of Erectile Function (IIEF-5), the Premature Ejaculation Diagnostic Tool (PEDT), and the Male Sexual Health Questionnaire–Ejaculatory Dysfunction Short Form (MSHQ-EjD-SF). Results: Overall, 249 sexually active men were analyzed. No significant changes in erectile or ejaculatory function were observed in the overall cohort at either follow-up point. In contrast, among 132 men diagnosed with prostate cancer, significant declines were observed in IIEF-5, PEDT, and MSHQ-EjD-SF scores at both 1 and 3 months compared to baseline (all p < 0.001). Conclusions: Transperineal prostate biopsy minimally affects sexual function in the general population. However, prostate cancer patients experience notable deterioration in erectile and ejaculatory outcomes, which may be a transient decline, and long-term follow-up is necessary for this subgroup.

Objective: To evaluate molecular, immunohistochemical, and radiological parameters associated with pathological upgrading in patients with ISUP Grade Group 1 (GG1) prostate cancer who underwent radical prostatectomy (RP). Methods: A total of 106 patients diagnosed with ISUP GG1 prostate adenocarcinoma via needle biopsy and treated with RP between 2012 and 2022 were retrospectively analyzed. Based on final pathology, patients were categorized into No Upgrade, Low‐risk Upgrade, and High‐risk Upgrade groups. Biopsy specimens were evaluated for PTEN, ERG, and Ki‐67 expression and TMPRSS2‐ERG gene fusion status, while radiological parameters, including PI‐RADS v2.1 scores and ADC values (ADC _tumor and ADC _ratio ), were assessed based on preoperative multiparametric MRI. Results: TMPRSS2‐ERG fusion positivity and elevated ERG expression were significantly more common in the High‐risk Upgrade group ( p < 0.01 and p = 0.04, respectively). PI‐RADS scores showed a stepwise increase, and ADC _tumor values decreased across risk groups ( p = 0.01 and p = 0.03). No significant differences were observed for PTEN loss, Ki‐67 index, or ADC _ratio . Conclusion: Certain immunohistochemical, radiological, and molecular parameters may be predictive of pathological upgrading in GG1 prostate cancer. Incorporation of these biomarkers into diagnostic evaluation and treatment planning may aid in refining risk stratification and avoiding overtreatment in clinically indolent cases. Although ADC _tumor values were significantly associated with upgrading, their correlation with molecular markers such as PTEN, ERG, Ki‐67, and TMPRSS2‐ERG fusion were not statistically significant. Trial Registration: Project No: 2023TIPF001

Background/Objectives: Conventional imaging modalities are often inadequate for evaluating the proximal extent of anterior obliterative urethral strictures. Magnetic Resonance Imaging (MRI), with its superior soft tissue resolution, provides detailed anatomical insights and significantly contributes to surgical planning in such cases. Methods: Four male patients aged 26–63 years with anterior obliterative urethral strictures were evaluated using MRI in addition to conventional imaging. All MRI scans were performed following a modified Joshi protocol. Clinical data, MRI findings, and surgical outcomes were retrospectively reviewed. Results: MRI successfully delineated stricture length, location, periurethral fibrosis, and proximal urethral status in all cases, correlating well with intraoperative findings. Case 1 showed a 2 cm proximal bulbar obliteration, excised with end-to-end anastomosis. Case 2 had a 2.5 cm distal bulbar stricture, managed similarly. Case 3 revealed multi-segmental strictures, treated with a combination of anastomosis, graft, and Kulkarni urethroplasty. Case 4 demonstrated a rare 9 cm distal penile obliteration with preserved proximal urethra, treated with anastomotic repair. MRI provided critical anatomical detail for surgical decision-making. Conclusions: MRI is a valuable imaging modality for the evaluation of anterior obliterative urethral strictures, particularly when the proximal extent of the stricture cannot be visualized with conventional imaging techniques. In our case series, MRI enabled precise delineation of the stricture length and surrounding anatomical structures, which was critical for selecting the most appropriate surgical approach.

Background/Objectives: Benign prostatic hyperplasia (BPH) is a prevalent condition in aging men and a major cause of lower urinary tract symptoms (LUTSs). While traditional treatments such as transurethral resection of the prostate (TURP) are effective, they are associated with notable morbidity. Ultrasound-guided transperineal laser ablation (TPLA) has emerged as a minimally invasive alternative. This study aimed to assess the 12-month efficacy, safety, and functional outcomes of TPLA in patients with LUTS secondary to BPH. Methods: This was a single-center, retrospective observational cohort study including 53 patients with moderate-to-severe LUTS due to BPH who underwent TPLA between November 2021 and May 2024. Baseline and follow-up assessments were conducted at 1, 3, 6, and 12 months, including IPSS, Qmax, PVR, prostate volume (MRI), QoL, IIEF-5, and MSHQ-ED/Bother scores. The procedure was performed under local anesthesia using the EchoLaser™ system, and ablation was guided via real-time transrectal ultrasonography. Results: Statistically significant improvements were observed in IPSS (median decrease from 30 to 13), Qmax (5.5 to 13.0 mL/s), and PVR (200 to 85 mL). Prostate and adenoma volumes decreased by 41.2% and 58.3%, respectively. Quality of life scores improved, and erectile function remained stable. Ejaculatory function improved significantly based on MSHQ-ED and MSHQ-Bother scores. No major complications or conversions to surgery occurred. Conclusions: TPLA appears to be a safe, effective, and minimally invasive treatment modality for LUTS caused by BPH. It offers sustained symptomatic relief, prostate volume reduction, and preservation of sexual function, making it a promising alternative for patients unfit or unwilling to undergo invasive surgery.

Objectives: Complications related to penile prosthesis implantation surgery (PPI) can be categorized as infectious, non‐infectious organ/tissue damage, device failure, and patient/partner dissatisfaction. However, no scoring system has been established to assess both preoperative physical status and intraoperative risk factors. The Estimation of Physiologic Ability and Surgical Stress (E‐PASS) score was originally developed to estimate postoperative complication risk in gastrointestinal surgeries. It incorporates age, severe cardiac/pulmonary disease, diabetes mellitus, performance status index, American Society of Anesthesiologists (ASA) classification, blood loss, body weight, operative time, and skin incision length. This study aims to evaluate the feasibility of the E‐PASS scoring system in predicting postoperative complications following PPI. Methods: In this single‐center retrospective study, data of 56 patients who underwent PPI between 2015 and 2024 were analyzed. Demographics, preoperative physical condition parameters, and intraoperative risk factors were recorded. E‐PASS score and sub‐scores were calculated. Results: Postoperative complications occurred in 17 patients (30.4%). Patients with complications had higher performance scores, ASA scores, prior pelvic/penile/urethral surgeries, prior PPI history, and higher E‐PASS scores (preoperative risk score, surgical stress score, and comprehensive risk score [CRS]). A CRS cut‐off value of −0.1238 predicted complications (AUC = 0.75; 95% CI 0.62–0.88; p < 0.003). CRS above the cut‐off was associated with a 16.2‐fold increase in complication risk. Conclusions: The E‐PASS scoring system appears to be a reliable tool for predicting postoperative complications in patients undergoing PPI by incorporating both preoperative physical condition and intraoperative risk factors.

Objective: Bladder outlet obstruction is a relatively rare problem in women. Experience in diagnosing and managing female urethral stricture disease is limited. The literature emphasizes that urethral dilatation is usually not successful, but surgical reconstruction is successful. Physicians and patients want to obtain information from social media because surgery cannot be performed in every center. With this study, we aimed to make an integrative review of the quality of the information in YouTube videos in the field of female urethroplasty. Material and Method: Using the keyword female urethroplasty, we searched https://www.youtube.com/ for the last 5 years. Video features, quality, and reliability analysis were performed. The reliability and quality of the medical information in the videos were determined by the JAMA (Journal of American Medical Association) scoring system, the Global Quality Score (GQS), and the DISCERN questionnaire. Results: 39 videos out of a total of 49 were included in the study. India was the country with the most video uploads (43.6%). There was no significant correlation between DISCERN score and the number of views and video comment count (rho;-0.101 p=0.539, rho;0.018 p=0.924, respectively). The DISCERN score, GQS, and JAMA scores of videos from Academic institutions or societies were found to be higher than personal videos (p=0.037, p=0.037, p=0.001, respectively). Conclusion: Although there are limited videos about female urethroplasty on YouTube, the accuracy and reliability of the medical information in the most watched videos are low.