Adrenal incidentalomas (AI) are adrenal masses that are discovered during radiological examinations conducted for other reasons. In this study, we focused on the pathological and radiological properties of nonfunctional AI(NFAI) and the association with malignancy risk in our clinical series. A total of 186 patients underwent adrenalectomy between 2010 and 2017; of these, 76 (40.8%) patients with non-functional AI were included in the current study. The radiological and pathologic characteristics of these AIs were retrospectively analyzed to determine the malignancy rate. There were 22 (28.9%) male and 54 (71.1%) female patients with nonfunctional AI included in this study. The median age was 55 (range: 24-85) years. Of the patients included, 37 (48.6%) had AI on the left and 39 (51.3%) had AI on the right adrenal gland. Sixty-one (80.2%) cases were treated laparoscopically, four (5.3%) required conversion to open surgery due to intraoperative difficulties such as bleeding and adhesions, and 11 (14.4%) were managed with open adrenalectomy. The rate of malignancy in the tumors with diameters of 6 cm was found to be 0%, 2.9%, and 13.6%, respectively. Determining the ideal cutoff value for surgical indication in an NFAI is challenging. Besides the malignancy risk, the rate of silent pheochromacytomas must be taken into account in the surgical decision.

Background Multiple renal arteries (MRA) in a donor kidney can increase surgical complexity in living donor kidney transplantation. However, the impact of MRA on early transplant outcomes, including delayed graft function (DGF) and early graft failure, remains unclear. Methods We performed a single-center retrospective cohort study of 1,200 living donor kidney transplants conducted between 2019 and 2024. Donor kidneys were classified as having a single renal artery or multiple renal arteries (two or more). Recipient and donor characteristics, intraoperative details (ischemia times, vascular anastomosis technique), and postoperative outcomes (delayed graft function [DGF], primary nonfunction, and graft survival) were compared between the two groups. Logistic regression analyses were used to examine associations between MRA and the risk of DGF or graft failure within the first 90 days, both before and after adjusting for prespecified covariates. Results Of the 1,200 transplanted kidneys, 882 (73.5%) had a single artery and 318 (26.5%) had multiple arteries. Although the median cold-ischemia time was longer for multi-artery grafts (35.2 min vs. 29.4 min, p = 0.004), there were no significant differences in donor or recipient baseline characteristics. Multivariable logistic regression revealed no significant association between MRA and either DGF or early graft loss. Kaplan–Meier curves, censored for death, demonstrated similar graft survival in both groups (log-rank p = 0.25). Conclusions In this single-center cohort of living donor kidney transplants, grafts with multiple renal arteries did not exhibit an elevated risk of DGF or early graft loss. While additional surgical complexity is often required for MRA grafts, our findings suggest that these kidneys remain a safe and effective option for transplantation, supporting their broader use to expand the donor pool.

Background: Health literacy (HL) and irrational beliefs about happiness significantly influence adults’ health-related quality of life (HRQoL). The purpose of this study was to examine whether irrational happiness mediates the relationship between HL and HRQoL among adults. Methods: A total of 686 adults (468 women and 218 men; mean age = 22.30 ± 6.83 years) completed self-report questionnaires, including the Health Literacy Scale-Short Form, the EUROHIS-QOL 8, and the Irrational Happiness Beliefs Scale. Data were analyzed using structural equation modeling and bootstrapping methods. Results: HL had both direct ( β = 0.260, p < 0.01) and indirect effects on HRQoL. HL directly predicted irrational happiness ( β = –0.369, p < 0.01), which in turn directly predicted HRQoL ( β = –0.318, p < 0.01). Specifically, irrational happiness significantly mediated the relationship between HL and HRQoL (bootstrap coefficient = 0.117, 95% CI = 0.071–0.175). Conclusion: These findings suggest that interventions aiming to enhance adults’ HRQoL should consider not only improving HL but also addressing irrational beliefs about happiness.

Objectives: Perianal abscesses are frequently encountered in clinical practice and are primarily attributed to a cryptoglandular origin. Despite prompt incision and drainage, a subset of patients still develop anal fistulas. This study aims to identify risk factors associated with fistula formation after perianal abscess management. Methods: A total of 145 patients (64 females, 81 males) with perianal abscess were retrospectively reviewed between 2020 and 2024. All underwent urgent incision and drainage under anesthesia. Demographic characteristics, comorbidities, type of surgical intervention, and postoperative outcomes were analyzed. Postoperative complications were assessed at both early (≤30 days) and late (>30 days) time points. Univariate and logistic regression analyses were conducted to determine independent predictors of fistula formation. Results: The median patient age was 42 years (IQR: 35-50), and 37.9% had at least one comorbidity (17.2% diabetes mellitus, 13.8% hypertension). Intraoperative fistulas were identified in 37.9% of cases and managed via fistulotomy or seton placement when feasible. Early postoperative complications occurred in 24.1% of patients, most of which were minor. Over a median follow-up of 7 months (IQR: 4-12), abscess recurrence was observed in 6.9% and new-onset fistula in 14.5%. Comorbidities such as diabetes mellitus were associated with a higher likelihood of fistula formation. Anal incontinence was documented in 2.8% of patients, most cases resolving spontaneously or with conservative measures. Conclusions: Although urgent incision and drainage generally yields favorable early outcomes, a notable proportion of patients develop late complications, particularly fistula formation. Close follow-up and tailored surgical strategies, including fistulotomy or seton placement when indicated, may help reduce morbidity. Prospective and multicenter studies with extended follow-up are warranted to further refine treatment protocols and identify high-risk individuals.

Objective: Kidney transplantation is the most effective treatment for end-stage renal disease, but the shortage of cadaveric donors has increased reliance on living donors. Traditional open donor nephrectomy, while effective, is associated with significant morbidity. Hand-assisted laparoscopic donor nephrectomy (HALDN) combines the advantages of minimally invasive surgery with the tactile feedback of open surgery. This study presents the outcomes of HALDN procedures performed at the center. Methods: A total of 1221 living donor nephrectomies performed between September 2009 and August 2021 at Medicana İstanbul Hospital were analyzed. Donor characteristics, surgical details, and postoperative outcomes were recorded. Data analysis was conducted using SPSS version 22.0, with continuous variables assessed for normality and expressed accordingly. Results: Donor ages ranged from 19 to 87 years (mean 48.50 Å} 12.75 years), with 54.8%female donors. The average body mass index (BMI) was 27.99 Å} 3.7 kg/m2. Left-sidednephrectomies constituted 78.5% of cases, with HALDN performed in 94.7% of thesesurgeries. Warm ischemia time averaged 99.21 Å} 56.67 seconds. The average blood loss was 70 mL, and the mean hospital stay was 4.12 Å} 1.2 days. Complications included conversion to open surgery due to bleeding in 3.3% of cases, postoperative atelectasis (0.6%), incisional hernia (0.33%), wound infection (0.16%), and scrotal swelling (0.25%).The findings indicate that HALDN is a safe and effective method for donor nephrectomy,aligning with similar studies regarding operation and warm ischemia times. The minimally invasive nature of HALDN contributes to shorter hospital stays and quicker postoperative recovery. The rate of conversion to open surgery was within acceptable limits, and complications were manageable. Obesity (BMI > 30 kg/m2) was identified as a risk factor for incisional hernia, suggesting the need for careful surgical technique in this group. Conclusion: Hand-assisted laparoscopic donor nephrectomy offers a minimally invasive, safe, and effective alternative for living donor nephrectomy, enhancing donor recovery and potentially encouraging organ donation. Its adoption may play a significant role in reducing the number of patients awaiting organ transplants. Cite this article as: .i.ek SNK, Huseynov A. Laparoscopic hand-assisted donor nephrectomy: A decade of single-center experience and outcomes. Urol Res Pract.2024;50(6):355-358.

BACKGROUND Knowledge about organ donation and transplantation plays a crucial role in shaping individuals' health behaviors and perceptions, potentially impacting their health-related quality of life (HRQoL). Future anxiety, defined as the anticipatory worry individuals experience regarding potential negative events and outcomes in their future, may further influence these outcomes. AIM To investigate the effect of such knowledge on HRQoL and to examine whether future anxiety mediates this relationship. METHODS A cross-sectional study was conducted with 659 participants aged 18 to 65 years. Participants completed the Organ Tissue Donation and Transplantation Knowledge Scale, the Dark Future Scale, and the European Health Interview Survey-Quality of Life 8. Correlation analyses were performed, followed by Structural Equation Modeling to test the proposed mediation model. RESULTS The findings indicated that greater knowledge about organ donation and transplantation was positively associated with higher HRQoL and negatively associated with future anxiety. Future anxiety was negatively correlated with HRQoL. Structural Equation Modeling analysis indicated that knowledge directly enhanced HRQoL and reduced future anxiety. Additionally, future anxiety negatively affected HRQoL, mediating the relationship between knowledge and HRQoL. The mediation effect was significant, as confirmed by bootstrapping (bootstrap coefficient = 0.068, 95%CI: 0.046-0.093). CONCLUSION The study concludes that future anxiety partially mediates the positive impact of knowledge about organ donation and transplantation on HRQoL. These results suggest that increasing public knowledge in this area may reduce future anxieties and enhance quality of life.