Ümit Uysal

Background/Objectives: Chronic scrotal pain can affect daily life, sexual function, and psychological well-being. We examined publication characteristics and dictionary-defined treatment and patient-related terminology in titles and abstracts. Methods: We conducted a cross-sectional bibliometric study with exploratory dictionary-based content analysis of PubMed records retrieved using a consolidated search on 31 October 2026, retaining a publication-date cutoff of 10 September 2026 and using OpenAlex citation and affiliation metadata from 31 October 2026. Following the initial assessment, two urologists independently assessed eligibility for a stratified sample of 85 records and concept coding for a stratified sample of 60 publications during revision. Performance of the unchanged dictionary was evaluated against the manual codes for these 60 publications. Seven overlapping categories were assessed in combined titles and abstracts of publications with abstracts. Sensitivity analyses varied eligibility scope and publication types; the original and consolidated datasets were also compared. Results: Of 421 screened journal records, 278 publications from 1979–2026 formed the core corpus. OpenAlex matched 275 publications, with 5216 citations and a corpus h-index of 39. The United States contributed to 131 publications; international collaboration occurred in 23/252 publications with country data (9.1%). Among 232 publications with abstracts, the dictionary matched treatment/management expressions in 84.5%, pain scales/scores in 24.6%, quality of life/function in 18.5%, psychosocial/mental health in 12.9%, sexual symptoms/function in 8.2%, satisfaction/global improvement in 3.9%, and recurrence/durability/reintervention in 11.2%. Treatment/management generated the highest dictionary-match frequency across sensitivity analyses (78.0–82.6%). Internal evaluation showed category-dependent sensitivity, including 22.2% for satisfaction/global improvement and 29.6% for recurrence/durability/reintervention. Conclusions: In this exploratory analysis, the broad treatment/management category generated the most dictionary matches. Unequal category breadth and sensitivity limit direct comparisons; infrequent or absent title/abstract matches do not establish that patient-centered outcomes were unmeasured, inadequately assessed, or unreported in the full text.

Enfeksiyon ve inflamasyon, erkek üreme fonksiyonlarını olumsuz etkileyebilen ve infertilite değerlendirmesinde dikkatle ele alınması gereken süreçlerdir. Bu bölümde, erkek genital sistem enfeksiyonlarının ve steril inflamasyonun sperm üretimi, olgunlaşması ve fonksiyonu üzerindeki etkileri; doğrudan mikrobiyal hasar, oksidatif stres, immünolojik yanıt ve duktal obstrüksiyon çerçevesinde incelenmektedir. Üretrit, prostatit, epididimit ve orşitin yanı sıra cinsel yolla bulaşan enfeksiyonlar, viral etkenler ve seminal mikrobiyom ele alınmaktadır. Enfeksiyon, kolonizasyon ve lökositospermi arasındaki ayrım vurgulanarak semen analizi, mikrobiyolojik testler ve seçilmiş ileri incelemelerin klinik kullanım alanları ve sınırlılıkları açıklanmaktadır. Güncel kılavuzlar ve bilimsel kanıtlar doğrultusunda etkene yönelik tedavi, eş değerlendirmesi, korunma ve yardımcı üreme tekniklerinin planlanması tartışılmaktadır. Antibiyotik, antiinflamatuvar ve antioksidan tedavilerin fertilite sonuçlarına katkısına ilişkin belirsizlikler değerlendirilmektedir. Semen parametrelerindeki iyileşmenin gebelik veya canlı doğum artışıyla eş anlamlı olmadığı özellikle belirtilmektedir. Bölüm, gereksiz test ve tedavilerden kaçınan, klinik bulgulara ve çiftin üreme hedeflerine dayanan bireyselleştirilmiş bir yaklaşım sunmaktadır.

Background/Objectives: Urge incontinence (UI) is a condition defined as the involuntary loss of urine, affecting both women and men. The underlying pathophysiology is not completely understood, but it might involve the functioning of the autonomic nervous system (ANS) and the hypothalamic–pituitary–adrenal (HPA) axis, i.e., two main stress axes of the body. Therefore, the present study aimed to investigate the association of ANS and HPA axis activities with urge incontinence in female and male genders. Methods: For this purpose, four groups were established: (i) female patients with UI (n = 57), (ii) female control participants (n = 56), (iii) male patients with UI (n = 57), and (iv) male control participants (n = 57). ANS activity was assessed by heart rate variability (HRV) derived from a 5-min electrocardiogram (ECG) recording, and HPA activity was evaluated by salivary cortisol levels. HRV parameters consisted of both time- and frequency-domain parameters, notably the low frequency/high frequency (LF/HF) ratio, which is commonly interpreted as an index of sympathovagal balance. Results: Body mass index and age were higher in UI patients (p < 0.001). Cortisol levels did not differ significantly between groups (p > 0.05), whereas frequency-domain parameters of HRV (including LF/HF) were significantly lower in patient groups (p < 0.05). Conclusions: The data suggest that incontinence might be associated with altered ANS activity, with no effect on HPA axis dysregulation. Decreased LF/HF might be associated with a decreased sympathetic urine retention mechanism with increasing age in UI patients. Moreover, the data also suggest that cardiac autonomic control (assessed by HRV) might be a sensitive, non-invasive, and cost-effective tool for studying autonomic control of bladder function.

Objectives: Large language models (LLMs) are increasingly being used in medical research and as clinical decision-support tools. This study aimed to compare the accuracy and reliability of responses generated by large language models in response to andrology-related questions. Materials and methods: Seventy questions concerning diagnosis, treatment, and general information were developed on the basis of the 2024 Andrology Guidelines of the European Association of Urology (EAU). These questions were submitted to three large language models, namely ChatGPT-4, ChatGPT-4o, and Google Gemini 2.0 Flash. The responses were independently evaluated by three senior urologists using a four-point rating scale. A total score (TS) > 9 indicated a good response, 6 ≤ TS ≤ 9 indicated a moderate response, and TS < 6 indicated a poor response. In addition, the self-correction capabilities of the models were evaluated, and changes in response accuracy after re-evaluation were analyzed. Results: ChatGPT-4o achieved the highest total scores in the diagnosis and treatment categories ( p < 0.001). Google Gemini 2.0 Flash generated the longest responses but demonstrated the lowest accuracy. ChatGPT-4o also showed the greatest improvement following the self-correction process (Cohen’s d = − 1.214, p < 0.01). Fleiss’ kappa coefficient values ranged from 0.61 to 0.80, indicating substantial interrater agreement among the urologists. Conclusion: ChatGPT-4o emerged as the most reliable model for andrology-related questions, providing responses that are were highly consistent with current clinical guidelines. The self-correction capabilities of the models improved response accuracy, suggesting that error-awareness mechanisms in large language models have the potential for further refinement. Nevertheless, expert supervision remains essential for the safe implementation of AI-assisted systems in clinical practice.

Background: Accurate prediction of postoperative complications following radical nephrectomy is of great clinical importance for perioperative risk stratification and patient management. Although several scoring systems are used in urological surgery, there is no widely accepted, procedure-specific risk assessment tool. This study aimed to evaluate the performance of the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM), Estimation of Physiologic Ability and Surgical Stress (E-PASS), and its modified version (mE-PASS) in predicting postoperative complications after radical nephrectomy. As a secondary objective, the association between modified Glasgow Prognostic Score (mGPS), Prognostic Nutritional Index (PNI), and neutrophil-to-lymphocyte ratio (NLR), which reflect systemic inflammation and nutritional status, and postoperative complications was also investigated. Materials and methods: A total of 148 patients who underwent radical nephrectomy for renal tumors at our institution between January 2022 and March 2025 were retrospectively analyzed. Patients were divided into two groups based on the presence of postoperative complications. Postoperative complications were assessed according to the Clavien–Dindo classification, and complications of grade ≥ 2 were included in the analysis. Demographic characteristics, comorbidities, preoperative laboratory parameters, surgical variables, and postoperative outcomes were recorded. The predictive performance of the scoring systems was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC). Results: Postoperative complications were observed in 51 patients (34.5%). The POSSUM score demonstrated the highest predictive performance with an AUC of 0.810, showing high sensitivity (82.4%) and specificity (71.1%). The E-PASS score was also statistically significant but exhibited a more limited predictive performance (AUC: 0.682). In contrast, the mE-PASS score showed markedly lower predictive ability (AUC: 0.599). Patients who developed complications had significantly lower PNI values and higher NLR values ( p < 0.05). Additionally, intraoperative blood loss, tumor size, and length of hospital stay were significantly greater in the complication group ( p < 0.05). Conclusion: POSSUM and E-PASS may serve as useful tools for predicting postoperative complications following radical nephrectomy. However, given their moderate predictive performance and the limitations of the present study, these findings should be validated in larger, prospective, multicenter studies.

Aim: Our study aimed to evaluate the reliability and quality of YouTube videos related to testicular cancer and assess changes in their quality over time.Method: In July 2024, this study retrospectively analyzed publicly accessible YouTube videos. The first 172 videos retrieved using the keyword “testicular cancer” were evaluated. The videos were analyzed and scored using the modified DISCERN, Journal of the American Medical Association (JAMA), and Global Quality Scale (GQS) scoring systems. After applying the exclusion criteria, 151 videos were included in the final analysis.Results: The most common sources of the videos were health information websites and individual physicians/urologists. In our study, the mean JAMA, modified DISCERN, and mean GQS scores were 1.01 ± 0.92, 1.73 ± 1.32, and 1.79 ± 0.92, respectively. The average duration of videos uploaded after the onset of the coronavirus disease 2019 pandemic was significantly longer, whereas the average number of views was higher for videos uploaded during or before the pandemic. However, no statistically significant differences were found between the two periods in terms of JAMA, GQS, and modified DISCERN scores. Additionally, a positive correlation was observed between video duration and the modified DISCERN, JAMA, and GQS scores.Conclusion: Our study demonstrated that the quality of YouTube videos related to testicular cancer has not improved over time, and the production of low-quality content continues. Additionally, no significant change in video quality was observed after the pandemic.