Enhanced recovery after surgery (ERAS) protocols challenge the conventional and rigid methods of surgery and anesthesia and bring about novel changes that are quite drastic. The core principle of the protocol is to minimize the metabolic disturbance caused by surgical injury, facilitate the restoration of functions in a brief period, and promote the resumption of normal activity at the earliest. To compare the outcomes of ERAS and standard protocol for patients who have undergone radical cystectomy (RC) with ileal conduit urinary diversion. This prospective randomized controlled study was performed between 2015 and 2023. The 77 patients were divided into two groups ERAS (n=39) and Standard (n=38) by sequential randomization. These two groups are divided according to protocols of bowel preparation, anesthesia, and postoperative nutrition. The clinical and demographic characteristics of the patients, and the American Society of Anesthesiologists (ASA) and Eastern Cooperative Oncology Group (ECOG) scores were recorded. Perioperative findings, the degree of complications according to the Clavien-Dindo classification, and the total cost of treatment were recorded and analyzed. Length of hospital stay (18.82±9.25 day vs 27.34±15.05 day), and cost of treatment (2168,2±933$ 2879±1806$) were higher in the standard group. The rate of nausea and vomiting and the use of antiemetics were higher in the ERAS group compared to the standard group. In patients undergoing RC, the ERAS protocol was found to shorten the duration of hospitalization and reduce the total cost of hospital stay.

Background/Objectives: Bladder cancer, predominantly urothelial carcinoma, is an important malignancy of the urinary system. Despite the same histologic grade and stage, some patients seem to have a worse prognosis. In this context, the epithelial–mesenchymal transition (EMT), characterized by the loss of E-cadherin and gain of vimentin expression, is an important process in tumor progression. Galectin-3, a lactose-binding protein involved in various cellular processes, has been associated with increased tumor cell migration, invasion, and treatment resistance. Methods: In this study, 223 bladder cancer cases were examined, and E-cadherin, vimentin, and galectin-3 expression was evaluated by immunohistochemical staining in tumor budding areas and invasive components. These markers were also correlated with clinicopathological parameters, including tumor grade and stage. Results: The results indicated a significant decrease in E-cadherin expression and an increase in vimentin staining in higher-grade and higher-stage tumors, supporting EMT involvement. Galectin-3 expression was notably higher in T1 high-grade tumors but decreased in T2 stage tumors. Despite this, no significant correlation was found between galectin-3 and E-cadherin or vimentin, suggesting a complex role of galectin-3 in EMT. Conclusions: High galectin-3 expression in T1 high-grade tumors highlights its potential role in early tumor progression and as a therapeutic target. However, the decrease in its expression in advanced stages underscores the need for further research to understand its multifaceted involvement in bladder cancer. These findings suggest that while galectin-3 may contribute to the EMT and early tumor progression, its exact role and potential as a therapeutic target require more detailed investigation.

Background: Three-piece penile prosthesis implantation (PPI) is the gold standard treatment for refractory erectile dysfunction. Although infection rates have declined with improved surgical techniques and antibiotic prophylaxis, postoperative hematoma remains an early complication that may predispose to infection and device malfunction. The role of short-term closed-suction drainage in reducing these complications remains controversial. Aim: To evaluate whether placement of a 24-h closed-suction drain reduces postoperative hematoma, infection, and mechanical complications following primary three-piece PPI surgery. Methods: This retrospective comparative study included 410 patients undergoing primary penoscrotal three-piece PPI between September 2020 and August 2024. Patients were divided into a drain group (n = 149) and a no-drain group (n = 261). Demographics, comorbidities, operative characteristics, and postoperative outcomes were analyzed. Hematoma was assessed clinically and by ultrasonography on postoperative days 3 and 10. Patients were followed for 12 months. Comparative and multivariate statistical analyses were performed. Outcomes: Primary outcomes: Postoperative hematoma and infection. Secondary outcomes: Mechanical complications and risk factors associated with hematoma formation. Results: On postoperative day 3, hematoma was detected in 13.4% of the drain group and 8.8% of the no-drain group (P = .143). By day 10, rates were 16.8% and 13.0%, respectively (P = .298). Infection occurred in 2.0% of patients overall, with no difference between groups (P = 1.000). Mechanical complication rates were also comparable (2.7% vs. 4.2%, P = .427). Hematoma formation was significantly associated with infection (postoperative day 3, OR: 29.0; P < .001; day 10, OR: 10.6; P = .002) and prosthesis malfunction (OR: 4.67; P = .014). Smoking and lower body mass index were identified as independent risk factors for hematoma development. Clinical implications: Routine placement of a 24-h closed-suction drain does not appear to be associated with a reduction in postoperative complications after PPI. Preventive strategies should focus on meticulous intraoperative hemostasis and optimization of modifiable patient-related risk factors such as smoking. Strengths and limitations: The study includes a relatively large cohort and standardized ultrasonographic assessment. However, its retrospective design, exclusion of complex cases, and lack of standardized hematoma grading limit generalizability and causal inference. Conclusions: Routine use of a 24-h closed-suction drain in primary three-piece PPI surgery is not associated with a reduction in hematoma, infection, or mechanical complications. Hematoma formation remains a key determinant of adverse outcomes, emphasizing the importance of careful surgical technique and patient optimization rather than routine drainage.

Objective: The aim of this study is to determine how patients' expectations of healthcare services and physicians vary based on demographic factors such as gender, education level, and economic status, and to explore the relationship between these expectations and satisfaction. Additionally, it seeks to analyze the levels of dissatisfaction when these expectations are not met and how this information can contribute to the improvement of healthcare policies and practices. Material and Methods: A survey was conducted with 556 patients at a urology outpatient clinic between March and June 2023. Patients were asked 23 questions regarding demographics, clinical expectations, and satisfaction factors. Data were analyzed using the chi-square test. Results: The majority of participants were male (68.3%) and had low-income levels (73.7%). Most patients sought examination within 24 hours and expected an examination time of 5-15 minutes. Women's desire to reach their doctors by phone was significantly higher than men's (p=0.004). Higher education correlated with lower dissatisfaction rates even if hospital demands were unmet (p<0.0001). Low-income individuals were more likely to be dissatisfied with their doctors if unsatisfied with general hospital services (p=0.028). Middle-high income individuals were more likely to pay for examination by a preferred academic title physician (p=0.011). Conclusion: Patient expectations vary based on gender, education level, and economic status, significantly influencing satisfaction. Understanding these parameters can guide improvements in healthcare policies and practices.