Ahmet Anıl Acet

This study aimed to evaluate Turkish parents' perceptions and attitudes regarding the appropriate age for circumcision, practice conditions, and procedural indications across different regions of Turkey. This cross-sectional survey study was conducted between March 2023 and March 2025 across urology and pediatric surgery departments in seven distinct regions of Turkey. A total of 637 literate parents (aged ≥ 18) completed a voluntary 16-question online survey via a URL or QR code. Subgroup analysis was performed for parents whose sons had already undergone circumcision (n = 404). Data regarding demographics, circumcision preferences, and information sources were analyzed using descriptive statistics and Chi-square tests. The majority of parents (95.1%) considered circumcision necessary, primarily citing religious (77.7%) and medical (63.8%) reasons. Overall, 76% of participants stated that circumcision should ideally occur outside the psychologically sensitive period (PSP; ages 2-6). Among the 404 parents with already-circumcised sons, 41.1% (n = 166) reported that the procedure was performed during the PSP (ages 2-6). Awareness of the non-PSP increased significantly with higher parental education levels (p < 0.001). Regarding practice, specialists were preferred (pediatric surgeons 54.4%; pediatric urologists 46.3%), and the operating room was identified as the safest setting by 91.7% of respondents. Local anesthesia was the most preferred method (51.6%). Despite high awareness regarding specialist qualifications and clinical settings, a significant "knowledge-practice gap" exists concerning the timing of circumcision. Clinicians should proactively counsel parents regarding the psychological risks associated with the PSP, and public health strategies must move beyond general awareness to provide targeted guidance that ensures optimal timing in circumcision.

Urinary tract obstruction, resulting from various etiologies, is a significant clinical condition associated with substantial morbidity, including life-threatening sepsis and acute kidney injury. Prompt intervention for decompression via ureteral stenting or percutaneous nephrostomy is paramount. This study aimed to assess the practice patterns of urologists in Türkiye concerning percutaneous nephrostomy and to highlight its integral role within urological clinical practice. A cross-sectional study was conducted between 7th May 2022 and 31st May 2023 following institutional ethics committee approval. A 13-item questionnaire was distributed to 131 urologists of various academic ranks. The data were analyzed using the chi-square test. Of the respondents, 71% (n=92) reported competency in performing percutaneous nephrostomy, while 29% (n=38) indicated they could not. Regarding the ideal provider for percutaneous nephrostomy, 31% (n=41) advocated for urologists, 11% (n=14) for interventional radiologists, and 58% (n=76) supported a collaborative approach between both specialties. When asked about institutional practice patterns, 11% (n=14) reported that percutaneous nephrostomy was not performed, 38% (n=50) noted it was performed by urologists, 24% (n=31) by interventional radiologists, and 28% (n=36) by both specialties. Notably, 55% of urologists who do not perform percutaneous nephrostomy, regardless of academic rank, cited malpractice concerns as the primary reason. Percutaneous nephrostomy remains a fundamental procedure in urological clinical practice. Our findings suggest that its inclusion in urology residency training curricula is vital to ensure urologists retain their competency in percutaneous nephrostomy management. Comprehensive training and proficiency in percutaneous nephrostomy should be a core component of urology residency programs.

Objective: Priapism is a penile erection lasting more than four hours with or without sexual stimulation. Ischemic priapism lasting more than 48 hours is difficult to resolve with corporal aspiration, irrigation, and sympathomimetic injection. In such cases, shunt surgery may be necessary. The need for complicated surgeries such as penile prosthesis arises due to the development of fibrosis and erectile dysfunction. Our aim in this study is to present how we manage cases presenting to our clinic with late-stage priapism, accompanied by literature, and to draw attention to this issue. Method: We reviewed the retrospective analyses of patients with late-stage priapism who presented to our hospital between 2020 and 2024. We recorded the patient's demographic information and the procedures and surgeries performed. Results: We reached the data of five patients presenting with late-stage priapism. Although these patients were treated with intracavernous sympathomimetic irrigation along with aspiration, all of them required shunt surgery. T-shunt procedures were performed in all cases. The snake maneuver was applied in 2 of the 5 patients. A total of three patients developed erectile dysfunction. One of them underwent a penile prosthesis... Conclusion: According to our experience, it is tough to achieve detumescence in delayed priapism cases with only corporal aspiration and sympathomimetic injection, so we think that shunt surgeries and penile prostheses should be applied without delay.

Objective: This study aims to examine whether our region's Prostate Cancer (PCa) screening programs comply with the European Association of Urology (EAU) Guidelines. Method: This study was conducted as a retrospective, cross-sectional study between April 2014 and July 2022. Two hundred seventy patients who applied to our clinic for various reasons and were diagnosed with PCa were included in the study. Characteristics of the patients, such as age at diagnosis, comorbidities, age at first PSA examination, and PSA values, were recorded. Results: The mean age of the patients at the time of cancer diagnosis was 67.42±8.64 (43-91) years. PSA value (median±IQR) at the diagnosis was 9.58±19.43 (1.83-3437) ng/ml. When the distribution of cancer according to different decades of life was examined, there were 5 (%1.8) patients in the 40-50 age range, 44 (16.1%) in the 50-60 age range, 111 (40.7%) in the 60-70 age range, 86 (31.5%) in the 70-80 age range, and 24 (8.8%) after the age of 80. While 138 patients (51.1%) had local and benign tumor features, 59 (21.9%) patients were diagnosed with metastatic findings. Only 31.3% (61/195) of the patients were under regular follow-up by a specific urology doctor. Conclusion: It was found that the screening of prostate cancer, the most common type of cancer in men, was not performed by the guidelines, and as a result, diagnosis and treatment were delayed. It was determined that many patients lost the chance of curative treatment. In this disease, where early diagnosis is vital for effective treatment and preservation of quality of life, it is essential to follow up with aging men in accordance with the guidelines. It may be beneficial to periodically train and follow up with all health professionals interested in this issue.