Background and Objectives: Penile tissue loss, which can be an acquired condition due to trauma or infection, but is also seen in congenital anomalies, is a rare condition in children. A standard surgical approach is often not possible due to the different degrees and etiologies of penile tissue loss. The continuing growth and the presence of various congenital anomalies in children require a different penile reconstruction approach than in adults. We aimed to share our experience and surgical results with children in whom we performed penile reconstruction with different techniques due to penile tissue loss. Materials and Methods: Ten cases that underwent penile reconstruction between 2018 and 2023 were evaluated retrospectively. Age at initial operation, associated anomalies, surgical technique, and other related surgical attempts, as well as functional and cosmetic results, were recorded. Results: Ten boys aged between 6 months and 17 years underwent phalloplasty due to penile tissue absence. In six cases, penile tissue loss was due to acquired causes, and in four cases, congenital anomalies were the reason. The most common cause of penile tissue loss was circumcision complications. In four cases, penile reconstruction was achieved by mobilization of the remaining corpus cavernosum tissues, in two cases, the cavernous tissue was adequate and repaired with glansplasty and penile skin graft. Phalloplasty was performed by tubularization of a skin and subcutaneous fat flap, removed from the pubic region and scrotal region, in two cases. A microvascular radial forearm flap was performed in a 17-year-old patient with penile tissue loss because of trauma, and a free skin flap taken from the forearm was used for penile reconstruction. Thirty percent of patients required a second surgery. Urinary continence was present in eight of the cases. Although four cases were classified as cosmetically unsatisfactory in our evaluation, all patients and their families reported being satisfied with the cosmetic results. Conclusions: Penile reconstruction for penile tissue loss in children should be performed in clinics where different scenarios can be applied. With maximum preservation and mobilization of existing cavernous tissues, temporary penile reconstruction with local flaps should be performed in young children at an early stage to minimize the psychological effects of penile absence. Although an esthetically perfect result cannot be guaranteed, patients and families are generally satisfied with the outcome.

Ventral curvature (VC), and penile straightening is a key step in severe proximal hypospadias surgery. One of the most important variables in selecting the appropriate technique for primary severe hypospadias repair seems to be the urethral plate transection to achieve penile straightening. In some cases, cutting the urethral plate is not sufficient and VC is corrected with ventral corporotomies. In the presented study, it was aimed to evaluate the early results of patients who underwent urethral plate transsection (UPT). Thirty-two cases with severe proximal hypospadias who underwent chordee correction by transsection of the urethral plate between 2019 and 2022 years were evaluated retrospectively. The patients’ ages varied between 8 months and 16 years, with a mean age of 4.61 ± 4.10 years. Ventral curvature was below 90 degrees in 6 patients and above 90 degrees in 26 patients. Penile curvature was corrected by plate transection in 9 children (28.2%) and plate transection combined with ventral corporotomies in 23 children (71.8%). Bracka operation was performed on 8 cases, Duckett operation on 1 case, STAG operation on 8 cases, and STAC operation on 15 cases. We noted recurrence of curvature in 7 children (Bracka 3, STAG 2, STAC 2) which required dorsal plication during the urethroplasty. Second/third stage was completed in all children. Success, hematoma, fistula, meatal stricture, glanuler dehisence, graft stricture rates determined to be 53.2%, 6.25%, 12.5%, 12.5%, 6.25% and 9.37% respectively. Staged procedures give the oppurtunity to correct the residuel or recurrence curvature before urethroplasty. Follow up is important to address long term functional results of ventral corporotomies.

Objective: In this study, we aimed to evaluate the relationship between biochemical recurrence time and the “cancer of the prostate risk assessment post-surgery” score (CAPRA-S) after radical prostatectomy (RP). Material and Methods: Retrospective evaluation was made of the records of 328 patients applied with RP for a diagnosis of clinically localized prostate cancer. The patients were separated into groups according to the CAPRA-S score determined according to the preoperative PSA level and pathological characteristics of the RP specimen and the biochemical recurrence time after RP. Results: The mean follow-up period was 76.9±34.5 months. Biochemical recurrence was determined in 23.2% (n:69) of the cases, as early recurrence in 71% (n:49) and late in 29% (n:20). According to the CAPRA-S score, 186 (62.4%) patients were classified as low risk, 66 (22.1%) as moderate risk, and 46 (15%) as high risk. The 3 and 5-year BRFS rates of all the patients were 88.9% and 81.8% respectively. Patients with a low CAPRA-S score were determined to have a statistically significantly higher 3 and 5-year BRFS rate than patients in the moderate and high groups. Early biochemical recurrence after RP was statistically significantly correlated only with lymph node involvement (OR: 2.42, 95% CI: 1.07-5.47, p=0.03). Conclusion: This study showed that the CAPRA-S score, which is effective in predicting the risk of biochemical recurrence after RP, was not effective in predicting the time of biochemical recurrence after RP. Keywords: Biochemical recurrence, CAPRA-S score, prostate cancer, radical prostatectomy

The aim of this study was to present our institutional experience with continent catheterizable channel creation, with or without bladder augmentation, and