Objective: Infectious complications after transrectal ultrasound-guided prostate biopsy (TRUS-PB) can range from asymptomatic bacteriuria and febrile or non-febrile urinary tract infection (UTI) to sepsis. Cleaning of rectal mucosa with topical antiseptics such as povidone iodine or chlorhexidine before the procedure are alternative prophylaxis methods. We aimed to investigate the effects of these two different topical antiseptic agents on infectious complications and their superiority to each other. Material and methods: The study was conducted with 200 patients. Rectal mucosa cleansings were performed in 50 patients with povidone iodine and 49 patients with chlorhexidine. The remaining 101 patients did not receive any antiseptic treatment. The results were examined according to the hospital admissions or hospitalization for the first 30 days after the procedure due to UTI, body temperature >38.5°C, sepsis, hematuria, rectal bleeding, and urinary retention. Results: The mean age of study population was 63.3±7.26 years, and the mean prostate specific antigen value was 13.96±29.5 ng/mL. Acute prostatitis occurred in 14 patients (7%), 9 of whom were hospitalized due to sepsis after TRUS-PB. Statistically significant less acute prostatitis was observed in those patients who were treated with topical rectal antisepsis (topical rectal antisepsis 2% vs. no rectal antisepsis 12.1%, p=0.01). Chlorhexidine and povidone iodine were not superior to each other in terms of inhibiting the development of acute prostatitis (chlorhexidine 2% vs. povidone iodine 2%, p=1.00). Conclusion: Rectal mucosal cleansing with chlorhexidine or povidone iodine before TRUS-PB prevented the development of sepsis due to acute prostatitis. We recommend that this effective method, which is easy to apply, cheap, reliable, easily tolerated should be used in all prostate biopsy practice. Cite this article as: Ergani B, Çetin T, Yalçın MY, Özbilen MH, Bildirici Ç, Karaca E, et al. Effect of rectal mucosa cleansing on acute prostatitis during prostate biopsy: A randomized prospective study. Turk J Urol 2020; 46(2): 159-64.

Background and objective: We investigated the ability of preoperative serum values of red blood cell distribution width (RDW), neutrophil lymphocyte ratio (NLR) and plateletcrit (PCT) to predict Fuhrman grades (FG) and tumor stages of renal cell carcinoma in patients who underwent radical nephrectomy. Materials and methods: Records of 283 patients that underwent radical or partial nephrectomy of renal masses at our clinic between January 2010 and April 2018, whose pathology results indicated renal cell carcinoma (RCC), and who had their FG and T1–4 N0M0 identified were retrospectively evaluated. The patients were divided into two groups based on their FG as low (I–II) and high (III–IV) and their T stages were similarly grouped as limited to kidney (pT1–pT2) and not limited to kidney (pT3–pT4). Results: Mean RDW, NLR, PCT cut-off values of the patients for FG and T stage were 15.65%, 3.54, 0.28% and 14.35%, 2.69, 0.28%, respectively. The RDW and NLR were determined to be statistically significant predictors of a pathologically high FG, whereas the PCT value was not a statistically significant predictor of high FG (p = 0.003, p = 0.006, p = 0.075, respectively). The relationship of RDW, NLR and PCT values with a limited to the kidney pathological T stage revealed statistically significant correlations for all three values. Conclusions: We determined that only RDW and NLR were markers predicting FG, while PCT had no prognostic value. On the other hand, all three of these values were associated with a limited to the kidney pathological T stage in patients who underwent nephrectomy due to renal masses and whose pathologies suggested RCC.

Background/aim: In this study, we aimed to compare the results of prone and Barts "flank-free" modified supine percutaneous nephrolithotomy (PCNL) operations in our clinic. Materials and methods: The data from patients that underwent Barts "flank-free" modified supine PCNL (BS-PCNL) (n = 52) between June 2018 and July 2020 and prone PCNL (P-PCNL) (n = 286) between April 2014 and June 2018 were retrospectively evaluated. Of those 286 patients, 104 patients whose sex, age, body mass index, American Society of Anesthesiology score, stone localization, stone size, and hydronephrosis matched the BS-PCNL group in a 1:2 ratio were included in the study. The groups were compared in terms of intraoperative outcome, complication rates, and stone-free rates. Results: The mean age of all patients (58 females, 98 males) included in the study was 41.8 +/- 15.2 years, and the mean body mass index (BMI) was 24.7 +/- 2.9 kg/m(2). The mean operation time was significantly shorter in the BS-PCNL group than in the P-PCNL group (80.2 +/- 15.1 min vs. 92.4 +/- 22.7 min and p = 0.01). There was no significant difference between the two groups in terms of fluoroscopy time, intraoperative complications, postoperative complications, and stone-free rates. Conclusion: Our study shows that BS-PCNL is an effective and safe method that significantly reduces the operation time and should be considered as one of the primary treatment options for patients scheduled for PCNL.

Purpose: To discern whether reduced infection rates were attributed to antiseptic solutions or mechanical rectal irrigation. Patients and Methods: After receiving ethical approval, the study included patients who underwent transrectal prostate biopsy due to elevated PSA or abnormal digital rectal examination findings, and prostate cancer under active surveillance, at Tepecik Training and Research Hospital between April 2022 and June 2023. Standard antibiotic prophylaxis was administered. Patients were randomized into three equal groups according to the rectal irrigation strategy. Results: Overall complications occurred in 4%. Despite distinct cleaning agents, there was no significant difference in infection rates ( p = 0.780) or fever incidence ( p = 0.776). Pathological analyses revealed comparable outcomes ( p = 0.764). Conclusion: The study challenges the prevailing belief that antiseptic solutions are indispensable for infection prevention, as saline demonstrated similar efficacy. Limitations include data gaps from potential external hospital visits and absent rectal microorganism swab culture. While TRUS-PB remains the gold standard, this study suggests that mechanically cleansing the rectal mucosa with saline—a cost-effective, side-effect-free alternative—may be a viable infection prevention method, particularly beneficial for patients with antiseptic allergies. The findings prompt a reconsideration of the necessity of antiseptic solutions in TRUS-PB, offering an alternative approach to mitigate infectious complications.