Background/Objectives: Rectal injuries are rare but serious complications during pelvic surgeries. This study aimed to share our experience with primary repair of rectal injuries occurring during pelvic uro-oncological surgeries. Methods: A total of 494 patients who presented to our clinic with diagnoses of non-metastatic bladder tumors and prostate cancer and underwent radical prostatectomy, and 214 patients who underwent radical cystectomy between 2010 and 2024 were included in the study. Data from 15 patients who experienced rectal injury during pelvic uro-oncological surgery were retrospectively reviewed. Patients scheduled for radical prostatectomy received rectal enemas twice a day (morning and evening) the day before surgery. Patients scheduled for radical cystectomy received a liquid diet for three days preoperatively, along with rectal enemas morning and evening. Results: Rectal injury occurred in 7 (1.4%) patients during radical prostatectomy and in 8 (3.7%) patients during radical cystectomy. All rectal injuries were detected intraoperatively. The defect was closed in two layers: muscular and serosal. Patients had no active complaints during follow-up, and no rectourinary fistula was observed. Conclusions: Intraoperative detection of rectal injury during pelvic uro-oncological surgery and high-quality primary repair of the defect play a critical role in preventing morbidity and mortality associated with rectal injury. Preoperative mechanical bowel preparation reduces contamination of the procedure, improves the visibility of the defect, and allows for high-quality primary repair.

The indications for surgical intervention in adolescent varicocele cases are restricted. When intervention is necessary, treatment options include the open subinguinal approach, laparoscopic surgery, or embolization. This study aimed to compare outcomes between microsurgical sub-inguinal varicocelectomy and laparoscopic varicocelectomy in adolescent patients. Forty-nine patients under 18 years old who underwent varicocelectomy between 2010 and 2023 were categorized into two groups based on the surgical approach 19 patients underwent laparoscopic varicocelectomy by pediatric urologists, and 30 patients underwent SV by the urology department. Patient records were retrospectively analyzed for age, preoperative symptoms, physical examination findings, ultrasound results, surgical techniques, and postoperative outcomes. There was no significant difference in recurrence rates between subinguinal varicocelectomy and laparoscopic varicocelectomy techniques. However, statistically significant differences were noted in operative duration, hospital stay length, and patient age at the time of surgery between the pediatric urology and urology department groups employing different techniques. Both subinguinal varicocelectomy and laparoscopic varicocelectomy techniques can be considered based on the surgeon's expertise and institutional resources. Regardless of the approach chosen, preserving arterial and lymphatic structures to maintain testicular blood supply and minimize complications is paramount.

Background and Objectives: The use of fluoroscopy during retrograde intrarenal surgery (RIRS) results in cumulative ionizing radiation exposure to both the patient and the surgical team. We aimed to evaluate the efficacy and safety of fluoroscopy-free (FF) RIRS performed by experienced surgeons in the management of renal stones < 2 cm. Materials and Methods: A total of 255 patients who underwent RIRS for renal stones < 2 cm between 2023 and 2025 were retrospectively analyzed. Patients were randomly assigned to the groups. Fluoroscopy was used (FU) during RIRS in 123 patients, whereas fluoroscopy was not used during RIRS in 132 patients. All procedures were performed by a single experienced surgeon. For patients in both groups, the following variables were retrospectively reviewed: demographic characteristics, stone characteristics, localization, and diameter, operative time, fluoroscopy time and dose, postoperative complications, length of hospital stay, and stone-free rates (SFR). Results: The operative time was 34.7 ± 8.7 min in the FF group and 42.0 ± 12.9 min in the FU group, being significantly shorter in the FF group (p < 0.001). No fluoroscopy was used in the FF group, whereas in the FU group the fluoroscopy time and dose were recorded as 7.75 ± 3.6 s and 1.31 ± 0.61 mGy, respectively. There were no significant differences between the groups in terms of length of hospital stay or SFR. No intraoperative complications were observed in either group. Postoperative complications occurred in 29 (21.9%) patients in the FF group and 42 (34.1%) patients in the FU group; the difference between groups was statistically significant (p = 0.030). Conclusions: In appropriately selected patients with renal stones < 2 cm, fluoroscopy-free RIRS performed by experienced surgeons can be applied effectively and safely, with shorter operative times and lower complication rates.