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    Before the Needle: The Impact of Ejaculation on Prostate Biopsy Outcomes in a Prospective Comparative Study
    (Springernature, 2025) Baba, Dursun; Dilek, Ismail Eyup; Ekici, Necati; Ozel, Mehmet Ali; Balik, Ahmet Yildirim; Basaran, Ekrem; Taskiran, Arda Taskin
    BackgroundAlthough transrectal ultrasound (TRUS)-guided prostate biopsy is widely used for prostate cancer diagnosis, the role of pre-biopsy ejaculation in influencing procedural outcomes and complication risk remains largely unexplored. This study aimed to evaluate whether recent ejaculation affects seminal vesicle volume, biopsy-related complications, and patient-reported outcomes.MethodsIn this prospective comparative study, 32 patients undergoing TRUS-guided 12-core prostate biopsy were divided into two groups based on their sexual activity: the ejaculation group (n = 14), who ejaculated within 24 h prior to the procedure, and the abstinence group (n = 18), who reported abstinence for at least 3 days. Data collected included seminal vesicle volume, pain scores, urinary symptoms, erectile function, quality of life, and post-procedural complications. Histopathological results were also recorded and summarized. ROC analyses were used to determine cutoff values for key complications. Although transperineal biopsy is now recommended by current EAU guidelines, our study was conducted using the transrectal approach, which remains widely practiced and relevant in clinical settings.ResultsWhile seminal vesicle volume tended to be higher in the abstinence group, the difference was not statistically significant (p = 0.184). No meaningful differences were found in pain perception, urinary symptoms, erectile function, or quality of life. However, hematospermia (p = 0.017) and hematochezia (p = 0.011) were significantly more frequent in the ejaculation group. ROC analysis showed that abstinence <= 7.5 days predicted hematospermia (AUC = 0.731), and abstinence <= 2 days predicted hematochezia (AUC = 0.760). A pain score >= 1.5 was predictive of hematuria (AUC = 0.810). Histological analysis revealed benign findings in the majority of patients, with no significant difference in cancer grade between groups.ConclusionEjaculation prior to TRUS-guided prostate biopsy may increase the risk of certain complications without negatively affecting patient comfort. Abstinence duration could serve as a simple and modifiable factor in optimizing biopsy preparation. Despite the limited sample size, this prospective study provides preliminary evidence supporting patient counseling on sexual activity prior to biopsy.
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    Can Laparoscopic Adrenalectomy Be A Reliable Method for Adrenal Masses Larger than 4 Cm?: Our Clinical Outcomes
    (Galenos Publ House, 2025) Senoglu, Yusuf; Balik, Ahmet Yildirim; Baba, Dursun; Taskiran, Arda Taskin; Basaran, Ekrem; Tekin, Ali
    Objective: The laparoscopic approach to large adrenal masses is becoming increasingly common. Our study aims to investigate the reliability and effectiveness of adrenalectomy performed with laparoscopic surgery in adrenal masses larger than 4 cm. Materials and Methods: Fifty-two patients who underwent transperitoneal laparoscopic adrenalectomy in our clinic between January 2014 and July 2022 were evaluated retrospectively. Each patient's age, gender, hormonal activity status, tumor size and side, hospital stay, amount of bleeding, operation time, complication rates (Clavian classification), pathology results, and surgical margin positivity were evaluated. Thirty patients with tumor size over 4 cm and 22 patients under 4 cm were compared separately. Results: There was no statistically significant difference between the two groups regarding hospital stay (p=0.11). When the operation time and bleeding amount were compared, no statistically significant difference was found between these two groups (p=0.392, p=0.761; respectively). Although slightly more complications were seen in patients with tumors smaller than 4 cm, no statistical difference was observed (p>0.05). Surgical margin positivity was detected only in one of the patients with a tumor size of less than 4 cm, and this patient was reported to have adenoma. All operations were completed laparoscopically. No complications occurred in Clavien class 3 or above in any of the patients. Conclusion: Our study and experience unequivocally demonstrate that transperitoneal laparoscopic adrenalectomy is not only effective but also remarkably safe for large (>4 cm) adrenal masses.
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    Complete urethral rupture accompanying penile fracture: a case report
    (Bmc, 2025) Baba, Dursun; Ekici, Necati; Taskiran, Arda Taskin; Senoglu, Yusuf; Basaran, Ekrem; Balik, Ahmet Yildirim
    Introduction and importancePenile fracture is a rare urological emergency. It occurs due to the penis being subjected to force during intercourse or other causes. Treatment is usually surgical. Urethral injury accompanies 10-20% of cases. In this case, a complete urethral rupture accompanying a penile fracture is aimed to be presented.Presentation of caseA 45-year-old male patient presented to the emergency department with complaints of a snapping sound, pain, and sudden loss of erection during sexual intercourse. After a while, bleeding from the external meatus and inability to urinate were added to his complaints. Physical examination showed typical signs of penile fracture along with urethrorrhagia. The penile doppler ultrasound result was reported to be consistent with a penile fracture and uretral injury. Approximately one hour after presenting to the emergency department, the patient underwent surgery. Considering the possibility of urethral rupture, a urethroscopy was performed before fracture repair, revealing a urethral defect approximately 8 cm proximal to the external meatus. Surgical repair found a near-complete bilateral rupture of the corpus cavernosum and a complete urethral rupture. The urethral rupture and fracture area were repaired according to surgical procedure standards. No additional complaints or new pathologies were observed in the early postoperative follow-up. The patient was discharged with a catheter on postoperative day 3. On the 14th postoperative day, the patient's catheter was removed. At the 3-month follow-up, the patient had no urinary complaints, and the uroflowmetry test showed a Qmax of 35. No pathology was detected in the urethrography performed. At the one-year follow-up, the patient's International Index of Erectile Function (IIEF) score was 26, indicating no additional complaints.Clinical discussionComplete urethral rupture and bilateral corpus cavernosum rupture are rare urological emergencies, typically resulting from trauma applied to an erect penis. A physical examination, ultrasonography, and, when necessary, imaging techniques such as cystoscopy are the diagnostic modalities employed in such cases. Early surgical treatment has been shown to improve functional outcomes and reduce long-term complications.ConclusionEarly surgical intervention in the treatment of penile fractures not only preserves sexual function but also significantly reduces long-term complications. Urethral rupture should always be considered in fractures accompanied by urethrorrhagia and hematuria.
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    Gestational Hydronephrosis: A Retrospective Analysis of the Clinical Outcomes of Ureteral Stent Placement Versus Conservative Treatment
    (Mdpi, 2025) Baba, Dursun; Yurtcu, Engin; Ayvacik, Burak; Kucuk, Yusuf Salih; Taskiran, Arda Taskin; Ozel, Mehmet Ali; Balik, Ahmet Yildirim
    Background and Objectives: Gestational hydronephrosis (GH) is a physiological condition commonly observed during pregnancy, resulting from hormonal effects and mechanical compression of the ureters by the enlarging uterus. Although often asymptomatic, GH can cause urinary stasis, recurrent infections, and renal function impairment in symptomatic cases. The optimal management of such cases remains controversial, especially regarding the role of ureteral stent placement. This study aimed to compare clinical outcomes-including renal function, inflammatory markers, and obstetric parameters-in pregnant women with symptomatic GH who underwent ureteral stent placement versus those managed conservatively. Materials and Methods: We conducted a retrospective cohort study at D & uuml;zce University Hospital between 2020 and 2024, including 40 pregnant women diagnosed with symptomatic GH. The patients were divided into the following two groups: those who received a ureteral stent (n = 20) and those who were managed with conservative treatment (n = 20). Conservative management included hydration therapy, acetaminophen-based analgesia, and close clinical monitoring. The parameters assessed included serum creatinine, estimated glomerular filtration rate (GFR), inflammatory markers (C-reactive protein, erythrocyte sedimentation rate, and white blood cell count), urinary findings, obstetric outcomes, and postpartum complications. Statistical significance was set at p < 0.05. Results: Gestational age at diagnosis was significantly higher in the stent group (29.1 +/- 3.2 weeks) than in the non-stent group (27.1 +/- 3.5 weeks; p = 0.045), possibly reflecting increased mechanical compression in later pregnancy. Renal function parameters (serum creatinine and GFR), inflammatory markers (CRP, ESR, and WBC count), and obstetric outcomes (birth weight, Apgar scores) showed no significant differences between groups (p > 0.05). Interestingly, gestational diabetes mellitus (GDM) was more prevalent in the non-stent group (20% vs. 5%; p = 0.042), although no significant differences were found in fasting glucose levels. Conclusions: Ureteral stent placement in symptomatic GH does not appear to significantly improve renal function or obstetric outcomes. However, it may provide symptom relief in select patients with persistent or severe discomfort. Given the limitations of retrospective data and a small sample size, further prospective studies with larger cohorts and quality-of-life assessments are warranted to optimize management strategies and enhance patient-centered care.
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    Treatment Strategies for Kidney Stones Following ESWL Failure: A Prospective Comparative Study of Three Surgical Approaches
    (Galenos Publ House, 2025) Baba, Dursun; Dilek, Ismail Eyup; Basaran, Ekrem; Senoglu, Yusuf; Balik, Ahmet Yildirim; Taskiran, Arda Taskin; Yuksel, Alpaslan
    Objective: This study aims to evaluate the efficacy and safety of retrograde intrarenal stone surgery (RIRS), mini-percutaneous nephrolithotomy (miniPCNL), and PCNL in patients with 1-2 cm kidney stones who failed extracorporeal shock wave lithotripsy (ESWL). Materials and Methods: This prospective study analyzed the medical records of 90 patients who underwent RIRS (n=29), miniPCNL (n=31), or PCNL (n=30) after unsuccessful ESWL treatment. The groups were compared based on operative time, hospital stay, complication rates, narcotic analgesic use, catheterization requirements, perioperative hemoglobin changes, transfusion needs, and treatment efficacy. Statistical analyses were performed using appropriate methods based on variable distribution. Results: RIRS resulted in significantly shorter hospital stays than miniPCNL and PCNL groups (p<0.001). MiniPCNL patients also had a shorter hospital stay than those in the PCNL group (p=0.047). The shortest operative time was observed in the PCNL group (59.9 min) compared to both the RIRS and miniPCNL groups (p<0.05). However, PCNL was associated with significantly higher narcotic analgesic use, greater hemoglobin reduction, and longer hospitalization. No significant differences were found among the three groups regarding transfusion requirements, residual stone rates, or overall complications. Conclusion: All three surgical methods were effective and safe for treating kidney stones measuring 1-2 cm in patients who previously failed ESWL. However, considering the shorter hospital stay and lower complication rates, RIRS and miniPCNL may be preferable options, while PCNL should be considered in selected cases.