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Öğe 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 TaskinBackgroundAlthough 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.Öğe 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, AlpaslanObjective: 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.